tvrt 


LIBRARY 

OF  THE 

UNIVERSITY  OF  CALIFORNIA. 

GIFT  OF 
THE    FAMILY  OF   REV.   DR.   GEORGE    MOOAR 

Class 


WITH    THE    COMPLIMENTS    OF 

BANCROFT 

SAN   FRANCISCO 
. 

Please  marl  us  copy  of  Paper  containin 


NERVE  WASTE 


PRACTICAL  INFORMATION 

CONCERNING 

NERVOUS      IMPAIRMENT 

AND 

NERVOUS    EXHAUSTION 

IN  MODERN  LIFE: 

THEIR  CAUSES,  PHASES  AND  REMEDIES 

WITH  ADVICE  ON  THE 

HYGIENE  OF  THE  NERVOUS  CONSTITUTION 


BY  H.  C.  SAWYER,  M.  D., 

MEMBER  OF  THE  MEDICAL  SOCIETY  OF  THE  STATE  OF  CALIFORNIA 
LATE  A.  A.  SURGEON  U.  8.  ARMY. 


SAN  FRANCISCO 

THE  BANCROFT  COMPANY 

1888 


Entered  according  to  Act  of  Congress  in  the  Year  1888,  by 

H.   C.  SAWYER 
In  the  office  of  the  Librarian  of  Congress,  at  Washington. 


INTRODUCTION. 

The  true  scope  as  well  as  the  powers  and  the  limita- 
tions of  the  medical  man  are  often  imperfectly  under- 
stood; the  various  functions  of  the  physician — cure,  alle- 
viation, prevention,  teaching — are  better  defined  by  the 
I,atin  cura,  care,  than  by  its  derivative,  cure,  in  its  modern 
sense.  To  care  for  the  health  of  the  whole  community 
is  a  far  wider  field  of  usefulness  than  to  cure  the  sick  in- 
dividuals in  it. 

In  his  work  of  curing  the  physician  is  too  often  viewed 
as  a  kind  of  sorcerer,  and  he  is  invoked  to  use  the  mys- 
terious chemical  substances  which  he  is  supposed  to  have, 
or  which  he  ought  to  have  ;  many  persons  imagine  that 
if  they  could  get  hold  of  the  doctor's  prescription-book, 
they  could  do  without  the  doctor. 

There  are  drugs  whose  action  is  so  sure,  and  surgical 
and  other  procedures  whose  results  are  so  radical,  that 
they  appear  almost  magical,  but,  in  the  large  proportion 
of  cases,  the  physician  is  far  from  being  a  magician,  and 
has  no  absolute  power  over  disease.  He  is  simply  one 
learned  in  the  science,  and  experienced  in  the  manage- 
ment of  sickness;  he  is  one  factor,  the  chief  of  all  the 
forces  operating  for  life  and  against  death;  the  patient, 
his  surroundings,  his  friends — sometimes  his  ancestors — 
influence  the  result  for  good  or  for  evil. 

The  power  of  the  physician  against  disease  and  death 
lies  in  his  trained  faculty  of  observation,  in  his  superior 
insight,  in  his  comprehensive  grasp  of  principles,  in  his 
profound  knowledge  of  all  the  conditions  which  are  for 


IA2 


INTRODUCTION 


and  against  life,  in  his  wiser  judgment,  and  in  the  author- 
ity or  the  influence  which  he  is  able  to  exercise  in  any 
particular  case.  These  qualities  often  enable  him  to 
nurse  the  flickering  flame  of  life  into  health  and  strength 
where  a  less  skillful  hand  would  extinguish  it  forever. 

Like  the  architect,  the  ship-master  and  the  general, 
the  doctor  is  a  director  of  forces,  a  supervisor,  an  exer- 
ciser of  good  judgment;  his  equipment  is  intellectual 
more  than  physical;  his  power  to  cure  is  oftener  in  his 
head  than  in  his  satchel. 

It  is  to  be  feared  that  the  physician  has  sometimes  per- 
mitted or  encouraged  an  exaggerated  estimate  of  his 
power;  he  is  human,  and  when  the  case  gets  well  he  has 
not  the  heart  to  dispel  the  illusion  which  inspires  such 
grateful  praises.  Perhaps  he  feels  that  these  are,  in 
some  measure,  his  due  to  offset  the  unjust  criticism 
which  all  physicians  receive.  But,  in  the  end,  any  mis- 
taken idea  of  his  power  is  apt  to  react  upon  the  physi- 
cian; when  he  fails  to  save  a  case,  which  no  power  on 
earth  could  save,  he  is  at  fault;  he  did  not  understand  the 
case;  he  did  not  know,  as  he  ought,  the  specific  for  this 
particular  disease.  The  interests  of  both  the  physician 
and  his  clients  are  best  served  by  an  intelligent  compre- 
hension of  the  scope,  the  powers  and  the  limitations  of 
medical  science. 

The  cure  of  disease  will  always  be  an  important  ele- 
ment of  the  physician's  work,  and  in  the  incurable  sick, 
the  alleviation  of  pain,  the  prolonging  of  life,  the 
affording  of  euthanasia  are  priceless  services;  but  the 
most  valuable  services  which  scientific  medicine  is  capa- 
ble of  rendering,  lie  in  the  direction  of  disease-preven- 
tion— in  the  family,  in  the  state  and  in  the  nation. 

At  this  time  the  policy  of  preventing  disease  rather 
than  curing  it  is  not  generally  understood  nor  appre- 


INTRODUCTION 


dated,  but  the  world  is  rapidly  growing  too  wise  to  neg- 
lect a  great  conservative  power  in  its  midst,  and  in  the 
future  this  function  of  the  medical  profession  will  be  more 
and  more  utilized.  A  ship  drifts  under  full  sail  upon  a 
tropic  sea,  a  glimmering  cloud  appears  upon  the  horizon, 
nothing  is  done;  the  cloud  grows,  but  is  still  unheeded; 
soon  the  storm  bursts  with  terrible  fury,  a  wild  rush  is 
made  to  take  in  sail,  but  it  is  too  late.  This  would  be 
criminally  bad  seamanship  but  it  is  an  illustration  of  what 
occurs  every  day  upon  the  uncertain  sea  of  life. 

The  efficiency  of  medical  men  will  be  immensely  in- 
creased when  their  relation  to  their  families  is  more  or 
less  constant,  instead  of  intermittent  and  irregular.  The 
doctor  should  come  and  go  like  the  clergyman  and  the 
priest;  instead  of  being  a  necessary  evil  whose  visits  are 
avoided  as  long  as  possible,  and  which  are  a  source  of 
uneasiness  when  necessarily  multiplied,  he  should  be  a 
minister  and  guardian  of  health,  an  officer  of  the  family 
upon  whose  special  wisdom  free,  early  and  constant 
reliance  is  placed.  His  counsel  should  have  great  weight 
in  a  hundred  personal  and  family  questions  which  influ- 
ence the  most  symmetrical  development  of  the  child  and 
the  preservation  of  the  man. 

The  eradication  of  inherited  tendencies  to  disease,  the 
direct  improvement  of  the  physical  and  mental  measure 
of  stocks,  the  development  of  a  hardy  constitution  in 
weak  children,  the  recognition  and  arrest  of  many  fatal 
organic  diseases  in  their  incipiency,  before  they  are  too 
old  to  be  controlled,  the  arrest  of  acute  inflammations  at 
a  time  when  this  is  possible,  the  insuring  of  longevity 
and  a  sound  old  age — these  are  some  of  the  things  which 
the  physician  of  to-day  is  able,  but  which  he  is  not  often 
permitted,  to  do. 

Teaching  is   an  important  function  of  the  physician; 


INTRODUCTION 


every  earnest  medical  man  is  ' '  doctor  ' '  in  deed  as  well 
as  in  name.  Medical  advice  in  the  abstract  is  often  barren 
of  influence;  medical  teaching,  which  conveys  clear  ideas 
of  pertinent  physiological  and  scientific  facts,  is  far  more 
impressive  and  fruitful.  As  in  all  teaching,  the  living 
voice  is  effective  in  a  greater  degree  than  the  printed  page 
can  ever  be;  the  talent  which  some  physicians  have  for 
clearly  illustrating  a  subject  or  emphasizing  a  fact  is  an 
important  element  in  their  success. 


Most  medical  men,  according  to  their  tastes  and  ex- 
periences, come  to  have  a  peculiar  interest  in  certain 
diseases;  such  an  interest  the  author  has  long  felt  toward 
functional  diseases  of  the  nervous  system. 

Nervous  Impairment  is  one  of  the  most  common  de- 
partures from  health;  it  is  a  subject  upon  which  consider- 
able  teaching  has  been  expended,  some  of  it  true,  much 
of  it  false.  The  experience  of  the  author  is  that  the 
popular  ideas — at  least  upon  the  subject  of  remedies — are 
frequently  vague  or  erroneous;  he  is  constantly  meeting 
with  persons,  in  the  field  of  his  daily  work,  to  whom  a 
realization  of  some  of  the  facts  attempted  to  be  explained 
herein  would  be  priceless;  and  he  has  thought  that  this 
short  statement  from  the  point  of  view  of  a  working  phy- 
sician might,  in  some  degree,  serve  a  useful  purpose. 

SAN  FRANCISCO,  DECEMBER,  1887. 

1320  MARKET   STREET. 


SYNOPSIS 


CAUSES 

Two  Classes  of  Causes,  n.  The  Epoch,  n.  The 
Nervous  Constitution,  12.  Over- work,  Over-activity, 
Tension,  Over-excitement,  Monotony,  12.  Worry,  17. 
School-life,  17.  Social  Duties  and  Excitements,  19.  Ex- 
cessive Child-bearing  and  Prolonged  Nursing,  20.  Stim- 
ulants and  Narcotics,  20.  Wrong  Sexual  Habits,  20. 
Local  Disorders,  20. 

THE  PHYSIOLOGY  OF  NERVE  FORCE 

The  Nervous  System,  21.  Functions  of  the  Nervous 
System,  22.  The  Sources  of  Nerve  Force,  24.  The 
Relation  of  Good  Food,  Good  Digestion  and  Pure  Air  to 
Nerve  Force,  25.  The  Relation  of  Sleep  to  Nerve  Force, 
25.  Consequences  of  Excessive  Nerve  Waste,  26. 

PHASES 

The  Symptoms  of  Nervous  Impairment,  27.  Various 
Types  of  Neurasthenia,  27.  Nervousness,  28.  Nervous 
Prostration,  28.  Altered  Personal  Appearance,  Thin- 
ness, Baldness,  Brittleness  of  the  Nails,  Flabby  Tis- 
sues, 29.  An  Unnatural  Fatigue,  31.  Mental  Phases, 
Mental  Irritability,  Depression  of  Spirits,  Impairment 
of  Memory,  Impairment  of  the  Faculty  of  Speech, 
Impairment  of  Will  Power,  32.  Circulation  Derange- 
ments, 36.  The  Vaso-Motor  Nervous  System,  Congestive 


SYNOPSIS 


Headache  and  Sleeplessness — often  Symptoms  of  a  Disor- 
dered Circulation, — Excessive  Blushing,  Hot  Flashes, 
Cold  Hands  and  Feet,  The  Irritable  Spine,  Ovary,  and 
Womb,  Spermatorrhoea  and  Impotency,  Weak  and  Irrita- 
ble Byes,  36.  Disorders  of  Secretion  and  Excretion, 
Excessive  Perspiration,  Unnatural  Dry  ness  of  the  Mouth 
and  Throat,  and  of  the  Skin,  38.  The  Irritable  Heart, 
Physiology  of  the  Heart,  Palpitation  of  the  Heart,  38. 
Reflex  Action  and  the  Part  it  Plays,  40  .  Headaches, 
and  Various  Head  Sensations,  Migraine,  41.  Neuralgia, 
and  Certain  Unpleasant  Sensations,  42.  Crippled  Func- 
tions, Impairments  of  the  Muscular  System,  Writers' 
Cramp,  Trembling  Fingers  and  Twitching  Muscles,  43. 
Disorders  of  Vision,  Hearing,  Taste  and  Smell,  45.  Weak- 
ness and  Alteration  of  the  Voice,  46.  Nervous  Indiges- 
tion, The  Great  Sympathetic,  Sudden  Breakdowns, 
Colic,  Falling  of  the  Bowels,  Dilatation  of  the  Stomach 
or  Bowels,  Reflex  Indigestion  in  Women,  Neuralgia  of 
the  Bowels,  46.  The  Relation  of  Nervous  Impairment 
to  Diseases  of  Women,  The  Irritable  Spine,  Ovary,  or 
Womb,  Suppression  of  the  Menses,  Hysteria,  50.  Nerv- 
ous Impairment  Connected  with  Disorders  of  the  Male 
Reproductive  System,  Description  of  Sexual  Neurasthe- 
nia, Spermatorrhoea  and  Impotence  are  Nervous  Diseases, 
Reflections  upon  this  Subject,  52.  The  Relation  of 
Nervous  Impairment  to  Longevity,  56.  The  Inconstancy 
of  Neurasthenic  Symptoms,  57. 


REMEDIES 

The  Curability  of  Nervous  Impairment,  58.  Princi- 
ples of  Treatment,  59.  Rest  as  a  Remedy,  Sleep,  The 
Management  of  Sleeplessness,  Change,  Advice  to  Those 
who  Must  Work  and  Cannot  Help  Worrying,  Rest  in  the 


SYNOPSIS 


Local  Forms  of  Nerve  Weakness,  61.  Oxygen  and  Ex- 
ercise,  Climate  as  a  Remedy,  The  Best  Kind  of  Exercise 
in  Nervous  Impairment,  67.  Concerning  Brain  and 
Nerve  Foods,  The  Physiology  of  Nerve  Nutrition,  What 
Fresh  Air  has  to  do  with  Nerve  Nutrition,  The  Most 
Valuable  Foods  for  the  Nervous,  70.  Tea,  Coffee,  Tobacco, 
and  Alcohol,  "Rejuvenators,"  "Restoratives,"  and  Beef, 
Iron,  and  Wine,  76.  Baths,  Cold,  Hot,  Local,  Sea  Bath- 
ing, The  Turkish  Bath,  78.  The  Use  and  Abuse  of 
Drugs,  Specifics,  Some  Facts  about  Phosphorus,  The 
Brain  and  Nerve  Poisons,  Chloral,  The  Bromides,  Coca, 
Cocaine,  Caffeine,  Indian  Hemp,  Advice  Concerning  the 
Use  of  Drugs,  So.  Local  Treatment,  The  Chief  Loccl 
Remedies  Used  in  Nervous  Impairment,  90.  Electricity, 
Varieties  of  Electricity  Used  in  Medicine,  Effect  of  the 
Electric  Current  Varies  with  Many  Circumstances,  The 
Dosage  of  Electricity,  Effect  of  the  Electric  Current  in 
the  Human  Body,  Uses  of  Electricity  in  Nervous  Impair- 
ment, Electric  Belts,  Some  Remarkable  Recent  Uses  of 
Electricity,  91.  Massage,  Manner  in  which  Massage 
Acts  as  a  Remedy,  "Magnetic  Healing,"  Massage  for 
Poorly  Nourished  Babies,  The  Mitchell  Treatment 
in  Nervous  Impairment,  95.  Aphorisms  in  Nervous 
Impairment,  96. 


NERVE  WASTE 


CAUSES 

The  causes  of  nervous  impairment  are  of  two  kinds: 
those  which  originate  without,  and  those  which  are 
developed  within  the  individual.  In  the  first  class  may  be 
placed  Environment  and  Heredity;  in  the  second  class  all 
those  countless  forms  of  nerve- waste  which  are  so  common 
in  modern  life,  and  which  may  be  pretty  completely  sum- 
med up  in  two  words,  Overwork  and  Dissipation. 

THE    EPOCH 

The  age  in  which  we  live  is  hard  upon  the  nervous 
system.  The  feverish  and  varied  activity,  the  changed 
and  changing  methods  of  life  and  work,  and  all  the  com- 
plicated conditions  of  existence  in  the  latter  half  of  the 
nineteenth  century  are  seen  to  be  having  a  distinct  causa- 
tive relation  to  functional  nervous  disease.  This  relation- 
ship has  been  frequently  pointed  to,  of  late  years,  by  both 
medical  and  lay  writers. 

The  factors  which  produce  nervousness  and  nervous 
debility  are  believed  to  be  more  numerous  and  active 
among  Americans  than  among  any  other  people.  The 
possibilities  of  man  in  America  are  great,  and  they  excite 
ambition — to  become  rich,  to  rise  in  the  social  scale,  to 
accomplish  objects  which  involve  struggle,  sacrifice,  anx- 
iety. A  somewhat  large  proportion  of  Americans  are 
unlocated  or  newly  located;  they  are  in  a  state  of  unrest 
and  insecurity  which  is  unfavorable  to  health .  The  climate 
of  a  large  portion  of  the  United  States  is  said  to  be  more 

bracing — to  permit  and  encourage  a  greater  amount  of 

(ID 


CA  USES 


nervous  expenditure  than  is  possible  in  any  other  part 
of  the  civilized  world.  And  lastly,  a  nervous  enfeeble- 
ment  or  susceptibility,  once  established  in  the  parents, 
is  transmitted  to  the  children,  who,  in  their  turn,  subjected 
to  the  same  influences,  develope  the  diathesis  in  a  still 
greater  degree. 

THE    NERVOUS    CONSTITUTION 

In  the  nervous  temperament  of  the  old  writers,  strength 
and  endurance  of  the  nervous  system  was  the  salient  fea- 
ture. By  reason  of  this  very  strength  and  endurance  the 
nervous  temperament,  in  the  stimulating  environment  of 
modern  life,  is  apt  to  undertake  too  much,  to  work  un- 
ceasingly or  to  dissipate  to  excess.  Thus  it  comes  about 
that  the  nervous  temperament  developes  an  irritable  and 
weakened  condition  of  the  nervous  system  instead  of  the 
endurance  which  was  one  of  its  original  characteristics. 
"Neurotic"  is  a  word  which  has  come  into  common  use 
in  modern  medical  literature  to  designate  this  state  of  more 
or  less  nervous  weakness,  and  susceptibility  to  some  form 
of  nervous  disorder. 

Neuralgia,  Sick  Headache,  "Neurasthenia,"  Nervous 
Dyspepsia,  Epilepsy,  St.  Vitus'  Dance,  Hysteria,  Asthma, 
Writers'  Cramp,  Hay  Fever,  some  forms  of  Insanity  and  a 
great  number  of  stimulant  and  drug  vices  are  directly 
founded  upon  the  neurotic  condition. 

OVERWORK 

The  elements  of  work  which  involve  excessive  nerve- 
waste  are  over-activity,  tension,  over-excitement  and 
monotony. 

Full  exercise  of  the  brain  is  favorable  to  health  and 
longevity;  it  inhibits  the  emotions,  strengthens  the  will 
and  acts  as  a  moral,  mental  and  physical  tonic.  Even 


CA  USES  IS 


prolonged  brain-work  is  not  necessarily  injurious  when 
unattended  by  hurry,  anxiety  or  excitement,  a  fact  which 
is  illustrated  in  the  biographies  of  innumerable  long-lived 
brain- workers,  and  mental  idleness,  plus  the  dissipation 
which  it  is  apt  to  engender,  is  one  common  cause  of  ner- 
vous impairment. 

An  incessant  mental  and  nervous  over-activity  seems  to 
be  inseparable  from  many  vocations.  Some  men  are 
habitually  stimulated  or  goaded  by  circumstances  into 
working  beyond  their  strength;  they  regularly  work  at 
high-pressure. 

The  exigencies  of  life  often  necessitate  spurts  of  work; 
the  lawyer  works  almost  night  and  day  for  weeks  on  an 
important  case;  the  inventor  pursues  some  promising  idea 
for  days,  neglecting  sleep  and  even  food.  In  many  com- 
mercial houses  there  are  periodically  recurring  busy  times, 
when  the  closure  of  the  doors  at  evening  does  not  end  the 
day's  toil,  the  wear  and  tear  goes  on  by  gaslight  till  late 
at  night  or  early  morning. 

The  young  and  the  strong  have  a  large  reserve  fund  of 
nerve-force  and  pass  through  these  periods  of  excessive 
work  without  permanent  injury.  But  the  individual 
whose  nervous  system  is  his  weak  part  is  subject  to  laws 
that  do  not  apply  toothers,  just  as  the  man  in  straightened 
pecuniary  circumstances  is  obliged  to  forego  expenditures 
that  are  scarely  felt  by  his  well-to-do  neighbors.  The 
relation  of  over-activity  to  nervous  disease  is  as  simple  as 
subtraction.  The  man  puts  out  more  than  he  takes  in, 
and  sooner  or  later,  according  to  the  extent  of  his  nerve- 
capital,  he  becomes  embarrassed,  crippled  or  fails  entirely 
in  his  vital  power. 

Many  occupations,  for  example  type-setting,  sewing 
machine  running,  or  vocations  which  require  prolonged 
standing,  involve  an  over-activity  of  certain  muscles  ;  as 


U  CA  USES 


a  result  a  worn  and  irritable  condition  of  that  portion  of 
the  spinal  cord  which  controls  the  nutrition  of,  and  sup- 
plies the  power  to  these  muscles  may  be  established. 

The  spinal  cord  is  a  highly  important  part  of  the 
nervous  system,  having  many  similarities  of  structure  and 
function  to  the  brain  ;  it  is  in  fact  a  continuation  of  the 
brain,  and  some  physiologists  look  upon  it  and  the  brain 
together  as  a  single  complex  organ.  When  local  irritation 
is  once  established  in  the  spine  it  may  irritate  and 
depress  the  whole  nervous  system  and  give  rise  to  many 
distressing  symptoms. 

The  tension  of  anxiety  so  common  among  manu- 
facturers, merchants  and  men  holding  responsible 
positions,  is  an  element  of  work  that  is  in  some  respects 
worse  than  mere  over-activity,  and  the  two  often  go 
together. 

If  a  long,  flexible,  finely  tempered  sword  be  supported 
at  its  extremities  and  subjected  to  a  moderate  weight  at 
its  middle,  it  will  bend,  and,  as  often  as  the  weight  is 
lifted  from  it,  will  fly  back  to  its  natural  shape,  though 
this  act  be  repeated  a  million  times;  if  an  excessive 
weight  be  brought  to  bear  upon  the  steel  it  is  snapped  in 
twain;  if  the  blade  be  subjected  to  the  strain  of  a  lesser 
but  still  too  heavy  weight,  it  will  yet  respond  up  to  a 
certain  point  of  strain;  if  the  too  heavy  weight  is 
maintained  during  months  and  years,  the  resiliency  and 
elasticity  of  the  blade  is  impaired,  the  sword  becomes 
crooked,  inelastic,  lifeless.  So  it  is  with  human  vitality  ; 
a  man  may  sustain  heavy  day  strain  throughout  a  long 
life,  if  the  succeeding  night  hours  are  periods  of  true 
relaxation;  it  is  the  carrying  of  business  cares  and 
worriments  over  night  that  impairs  the  fiber  of  the  delicate 
and  high-strung  nervous  organization  of  the  nervous 
constitution. 


CA  USES  15 


With  certain  workers,  as  locomotive  engineers,  bank 
tellers,  dentists,  the  largest  experience  and  the  most 
practised  skill  can  never  dispense  with  an  abnormal  vigi- 
lance, an  over-alertness,  which  kept  up  day  after  day, 
and  year  after  year,  is  wearing  in  the  extreme,  and  which 
not  unfrequently  proves  a  strain  that  breaks. 

Over-excitement  is  excessively  rapid  nerve- waste;  it  is 
tying  down  the  safety  valve  and  burning  lard  in  the  fur- 
nace. A  measure  of  excitement  is  good  for  the  brain  and 
nerves,  it  stirs  up  the  nutritive  processes,  cleans  out  the 
cobwebs,  and  leaves  the  mind  clearer  and  stronger  for  it. 
But  excessive  excitement  has  burned  the  youth  out  of 
many  a  brain  and  left  its  possessor  an  old  man  at  forty. 
The  stock-board  and  the  street  are  notorious  fields  of  shat- 
tered nerves  and  softened  brains,  and  every  year  the  ex- 
citement of  political  campaigns  makes  overdrafts  upon  the 
vitality  of  thousands. 

There  are  men  whose  work  involves  no  great  over- 
activity  nor  anxiety  nor  excitement,  and  yet  they  suffer 
from  the  monotonous  repetition  of  one  set  of  acts  and  im- 
pressions. The  whole  brain  is  not  uniformly  exercised  by 
any  act  nor  set  of  acts,  but  only  certain  parts  of  it.  So 
certain  impressions,  as  sights  and  sounds,  do  not  impress 
the  whole  brain,  but  only  small  areas  of  it  whose  function 
it  is  to  receive  and  take  cognizance  of  this  class  of  impres- 
sions. By  a  constant  harping  on  one  string  it  wears  out 
before  the  others.  By  a  continuous  exercise  of  one  set  of 
brain-cells  to  the  comparative  exclusion  of  others,  they 
become  tired,  then  exhausted  and  incapable  of  further  con- 
tinuance in  this  particular  groove  without  suffering  to  the 
individual.  Thus  the  book-keeper,  dealing  with  figures 
and  nothing  but  figures  year  after  year,  becomes  tired, 
listless,  inelastic  and  finally  incapable  of  work.  A  vaca- 
tion trip  to  the  seaside  or  the  mountains  benefits  him 


26  CA  USES 


immensely,  partly  by  the  power  of  pure  air  and  exercise > 
but  largely  because  the  overworked  areas  of  the  brain  are 
rested,  and  because  a  new  set  of  acts  and  impressions  ex- 
ercises other  brain-cells  that  needed  exercising. 


The  physiological  history  of  every  man  is  that  he  grad- 
ually matures,  then  for  a  few  years  is  at  the  maximum  of 
his  strength,  then  gradually  fails  to  old  age.  The  time 
when  a  man  is  at  his  best,  is  limited  to  a  few  years — 
champion  athletes  seldom  maintain  their  supremacy  ten 
years.  Such  men  may  appear  to  be  as  strong  or  stronger 
than  ever  before,  but  the  invisible  fountains  of  power,  deep 
in  the  nervous  structures,  have  begun  their  retrograde 
change,  their  day  is  passed,  and  in  the  race  some  fresher 
man  wins  the  prize.  The  amount  of  work  which  a  man 
can  easily  do  between  thirty  and  forty  should  not  be  his 
standard  of  achievement  in  later  years;  when  he  has  started 
to  descend  the  hill  of  life,  his  work  should  become  easier 
and  his  holidays  and  vacations  should  become  more  and 
more  frequent.  Unfortunately  this  is  not  often  possible; 
sometimes  an  acquired  inability  to  enjoy  anything  else  in 
life  but  work  is  one  of  the  bitter  elements  in  the  cup  of 
success,  but  more  often  stern  duty  toothers,  and  the  grind- 
ing competition  of  young  and  tireless  rivals  keep  the  older 
man  to  a  pace  beyond  his  failing  strength .  At  this  stage 
of  our  national  development  over-work  seems  to  be  an 
inevitable  condition  of  existence,  but  it  is  to  be  hoped 
that  increasing  prosperity  and  increasing  wisdom  will 
reduce  the  exactions  and  lessen  the  often  terrible  price 
which  men  pay  for  decent  success,  and  that  the  '  'gospel 
of  relaxation,"  preached  by  Herbert  Spencer,  may  become 
fashionable  in  the  land. 


CA  USES  17 


WORRY 

There  are  minds  that  no  trouble  can  injure — it  glides 
off  as  water  does  from  a  duck's  back;  it  does  not  sink  in 
and  corrode;  but  nervous  people  are  seldom  philosophical 
or  phlegmatic  enough  for  this.  Domestic  trouble  often 
aggravates  nervous  weakness,  and  instances  where  the  thin- 
ning and  rapidly  ageing  face  are  the  only  signs  of  silently 
borne  grief  are  within  the  range  of  everyone's  experience; 
the  skeleton  in  the  closet  is  oftener  revealed  to  the  physi- 
cian than  to  any  other,  and  his  skill  to  heal  often  stands 
helpless  before  its  power  to  wreck. 

Success  or  failure  in  life,  whether  accident  or  sequence, 
has  much  to  do  with  the  health  of  the  individual.  Suc- 
cess brings  friends,  favors  and  pleasant  words,  a  thousand 
little  amenities  that  smooth  the  road  of  life.  The  con- 
sciousness of  being  somebody,  of  cutting  a  good  figure  in 
the  world,  is  exalting  and  sustaining;  it  buoys  and  enables 
many  a  weak  man  to  accomplish  a  long  life  journey  that  he 
never  could  have  accomplished  had  the  way  been  rougher. 
Failure  depresses  and  irritates;  the  sensitive  mind  of  the 
man  who  has  failed  poorly  withstands  the  rebuffs,  the 
harsh  words,  the  neglect  or  the  scarcely  concealed  con- 
tempt of  his  fellows.  The  depressing  influence  of  disap- 
pointed ambitions  and  a  hopeless  future  is  sometimes  a 
powerful  obstacle  to  recovery. 

i 

SCHOOL    LIFE 

Anyone  who  is  often  abroad  at  the  hours  when  the 
children  are  going  to  and  from  school,  must  have  noticed 
that  a  certain  proportion  of  them  are  very  thin,  pallid,  and 
as  far  as  possible  from  the  normal  standard  of  plump,  rosy, 
healthful  childhood.  During  the  past  twenty  years  there 
has  been  no  lack  of  protest  against  what  Huxley  vigor- 
ously designated  "precocious  mental  debauchery"  and 


18  CA  USES 


1 '  book  gluttony  and  lesson  bibbing ' '  but  it  would  seem 
that  the  teacher  and  the  parent  can  not  often  be  made  to 
see  this  subject  from  the  point  of  view  of  the  physiologist. 

Over-pressure  and  over-application  are  relative  terms; 
what  is  over-work  for  one  child  may  be  easy  work  for 
another.  From  the  standpoint  of  the  physician  the 
routine  method  of  teaching  which  goads  every  one  of  fifty 
children,  of  widely  varying  physical  and  mental  strength, 
to  a  high  standard  of  accomplishment,  under  penalty  of  a 
certain  disgrace  at  school  and  at  home,  is  pernicious  in 
the  extreme. 

The  idea  that  exercise  strengthens  the  brain  and  mind 
is  true  up  to  the  boundary  line  in  the  individual  where 
exercise  becomes  over- work.  The  long  lessons,  the 
struggle  to  keep  up,  the  cramming  for  examinations,  all 
mean  the  expenditure  of  brain-force.  This  force  must  come 
from  somewhere;  the  brain  draws  upon  the  blood-current 
to  a  greater  extent  than  the  physiological  economy  of  the 
child  provides  for;  the  result  is  that  certain  chemical 
elements  of  the  blood,  which  ought  to  be,  and  naturally 
would  be,  converted  into  bone,  muscle  and  nerve  tissue, 
are  diverted  from  this  course,  by  the  demands  of  the  brain; 
the  bones  and  muscles  are  poorly  nourished,  and  the 
child  is  stunted  in  growth  and  never  becomes  the  man 
physical  or  mental,  that  he  might  have  become.  This  is 
the  story  of  the  undeveloped  muscles,  the  short  stature, 
the  physical  insignificance  of  thousands,  whose  parents 
before  them  were  large  and  handsome  specimens  of 
humanity. 

Many  intelligent  educators  recognize  these  facts,  but 
the  teacher  is  no  more  able  than  other  men,  to  work  a 
revolution  within  the  sphere  of  his  duty;  the  unwise 
ambition  of  parents  is  as  often  responsible  as  the  zeal  of 
the  teacher  for  the  nervous  disorders  arising  out  of  school- 


CA  USES  19 


life.  The  father  who  has  begotten  a  nervous  child  owes 
it  to  that  child  to  exercise  more  than  ordinary  care  in  its 
education;  school  honors  and  study  must  be  subordinated 
to  physical  development,  which  includes  the  physical 
brain  and  nerve  tissues  as  well  as  bone  and  muscle  tissues. 

If  such  a  child  cannot  keep  up  with  other  children  who 
have  inherited  strong  nervous  systems,  without  abnormal 
thinness,  headaches,  "nervousness,"  then  let  him  stay 
behind.  The  parent  should  never  encourage  such  a  child, 
by  rewards  or  by  reproaches,  to  become  first  in  his  class. 
Many  nervous  children  are  extremely  bright;  they  learn 
quickly  and  with  an  apparent  ease  which  gains  them 
praises  and  honors,  and  leads  the  parents  to  expect  and 
to  exact  great  things;  unfortunately,  experience  shows 
that  this  mental  precocity  is  not  often  maintained  in  after 
life. 

Instead  of  "The  mind  is  the  measure  of  the  man,"  it 
might  be  said  in  these  days  that  nerve-force  is  the 
measure  of  the  man,  so  important  a  part  does  this  quality 
play  in  the  battles  of  life.  The  man  who  at  thirty  finds 
himself  with  a  strong  nervous  system  has  in  it  a  posses- 
sion of  appreciable  coin  value.  Modern  life  demands  not 
omy  fine  work  but  a  quantity  of  it,  and  many  a  fine- 
worker  has  been  obliged  to  abandon  a  lucrative  position 
to  some  one  less  skillful,  for  lack  of  the  necessary 
staying  powers. 


Nervous  men  and  women  are  apt  to  be  fond  of  amuse- 
ments, and  of  the  excitements  of  social  life;  these  seem 
like  recreation  after  a  day  of  toil,  and,  in  some  degree, 
they  are  such.  But  when  they  are  carried  to  excess,  or 
when  they  involve  undue  excitement,  or  encroach  upon 
the  hours  of  sleep,  in  a  person  whose  nervous  system  is 


CA  USES 


weakened,  they  draw  steadily  upon  the  diminished  fund 
of  vitality.  There  are  many  forms  of  social  duty,  as  those 
incident  to  church,  lodge  and  politics  which  require  night 
work  without  being  in  any  degree  recreative,  and  which 
become  auxilliary  causes  of  nervous  impairment.  The 
effects  which  balls  and  parties,  the  habitual  reading  of  ex- 
citing fiction,  and  all  the  excitements  of  fashionable  life, 
alternating  with  sedentary  or  indolent  habits,  have  upon 
women  of  all  ages,  are  facts  which  physicians  have  fre- 
quent opportunities  to  note. 

Excessive  child-bearing  or  prolonged  nursing,  combined 
in  some  cases  with  household  drudgery,  sometimes  pro- 
duces a  general  enfeeblement  in  which  nervous  debility 
has  a  conspicuous  place.  The  over-use  of  tea,  coffee, 
tobacco  and  alcohol,  as  well  as  many  drug  habits  are 
often  met  with  as  exciting  causes  or  as  aggravating  ele- 
ments  of  nervous  impairment. 

Wrong  sexual  habits  are  among  the  most  frequent  forms 
of  excessive  nerve- waste;  not  only  the  abuses  and  excesses 
so  common  among  the  young,  but  certain  perversions  of 
the  natural  physiological  relations  of  marriage,  aimed  at 
the  prevention  of  conception,  which,  judging  from  my  own 
observations,  are  by  no  means  rare,  make  serious  over- 
drafts upon  the  nervous  resources. 

Finally  many  chronic  local  disorders — among  which  are 
eye-strains,  ear-strains,  irritations  about  the  upper  air  pas- 
sages, morbid  conditions  about  the  stomach  or  reproductive 
organs  in  either  sex — may  originate  or  exaggerate  exist- 
ing weakness  of  the  central  nervous  system.  The  manner 
in  which  these  local  conditions  act  will  be  more  fully  ex- 
plained on  subsequent  pages. 


THE  PHYSIOLOGY  OF  NERVE  FORCE 


THE  NERVOUS  SYSTEM 

The  central  nervous  system  consists  of  the  brain,  a  soft 
mass  of  gray  and  white  tissue,  which  fills  the  cavity  of 
the  skull,  and  the  spinal  cord,  a  white  cord  sixteen  inches 
in  length  and  about  the  thickness  of  a  lead  pencil,  which 
is  enclosed  in  the  bony  spine. 

To  the  anatomist  and  microscopist  this  nerve  tissue  ap- 
pears exactly  alike  in  all  human  beings,  but  the  invisible 
physical  differences  which  undoubtedly  exist,  constitute 
the  difference  between  the  mind  of  a  Napoleon  or  a  Crom- 
well, and  that  of  some  contemporary  simpleton.  This 
central  nervous  system  communicates  with  every  other 
part  of  the  body  by  means  of  long  white  conducting  nerves 
of  varying  thickness.  The  term  '  'nerve-cell' '  is  used  quite 
frequently  in  this  book  and  it  is  important  to  understand 
what  it  means.  The  cell  is  the  anatomical  basis  of  human 
flesh;  it  is  a  minute  mass,  spheroidal,  ovoid,  cylindrical, 
sometimes  shapeless.  A  typical  cell  consists  of  an  outside 
membrane,  and  an  enclosed  mass  of  protoplasm  which 
may  or  may  not  include  certain  germinal  spots,  the  nu- 
cleus and  the  nucleolus.  These  cells  are  extremely  small, 
it  is  estimated  that  the  spinal  cord  alone  contains  many 
millions  of  them.  An  aggregation  of  these  cells  is  called  a 
nerve-center,  and  these  nerve-cells  and  nerve-centers,  bound 
and  woven  together  by  fibres,  and  the  crevices  packed 
with  fat  and  connective  tissue,  make  up  the  structure 
known  as  the  brain  and  spinal  cord.  Besides  this  central 


M  THE  PHYSIOLOGY  OF  NERVE  FORCE 

nervous  system,  a  vast  number  of  nerve-cells  and  nerve- 
centers  have  been  placed  in  the  cavities  of  the  chest, 
abdomen  and  pelvis;  these  cells  are  independent  of  the 
will  but  are  dependent  upon  the  central  nervous  system 
for  their  vitality.  They  control,  regulate,  and  supply 
power  to  the  vital  organs  within  the  body;  they  act  as 
reservoirs  of  nerve-force,  and  with  their  connecting  nerves 
make  up  what  is  known  as  the  sympathetic  nervous 
system. 

THE    FUNCTIONS    OF   THE    NERVOUS    SYSTEM 

Are:  i. — Mind,  intelligence,  will,  emotion.  2. — Instinc- 
tive Action,  inherited  ability;  a  new-born  infant  almost 
without  mind  does  many  acts  instinctively.  3. — Auto- 
matic or  habitual  action;  many  acts  come  by  repetition 
to  be  automatic,  done  without  the  consciousness  of  the 
individual,  or  participation  of  mind ;  thus,  in  writing, 
the  mind  of  an  adult  is  not  often  concerned  in  the  spelling  of 
the  words,  nor  in  the  penmanship — they  have  become  auto- 
matic acts;  or,  one  may  play  correctly  a  tune  upon  a  musical 
instrument  while  the  mind  is  absorbed  in  some  other 
subject.  This  principle  of  habitual  action  has  an  impor- 
tant bearing  in  nervous  diseases.  Every  repetition  of  any 
act  makes  a  certain  impression  upon  the  nerve-centers  in 
the  brain  or  cord  which  renders  subsequent  acts  more 
and  more  easy;  this  is  the  history  of  all  skill  from  learning 
to  walk  to  the  most  difficult  performances  of  the  musician 
or  the  professional  gymnast. 

Thus  by  repetition  bad  habits  as  well  as  good  ones 
become  established  or  fastened  upon  us,  and  certain 
diseases  as  epileptic  fits  or  St.  Vitus'  dance  in  children, 
tend  to  become  more  and  more  a  habit,  or  easily  performed 
act  of  the  nervous  system. 


THE  PHYSIOLOGY  OF  NERVE  FORCE  23 

4. — Reflex  Action;  by  this  we  mean  that  a  sensation 
in  any  part  is  carried  to  the  spinal  cord  or  brain  by  the 
nerves,  and  thence  reflected  to  some  other  organ  or  part 
by  instinctive  action  or  otherwise.  A  man  touches  a  hot 
iron  and  draws  his  hand  away  almost  before  he  is  con- 
scious that  the  iron  is  hot;  the  painful  impression  is 
telegraphed  to  certain  nerve -centers  in  the  spinal  cord, 
and  instantly  they  telegraph  back  to  certain  muscles, 
which  withdraw  the  hand  from  the  iron.  The  mind 
may  not  be  concerned  at  all  in  this  process;  when  a  person 
is  tickled  during  sound  sleep  he  may  make  a  great  variety 
of  reflex  motions,  without  being  at  all  conscious  of  them. 

5. — The  Nutrition  and  Growth  of  every  tissue  and 
organ  is  under  the  direct  control  of  certain  nerve-centers 
in  the  brain  and  spinal  cord ;  every  tissue  is  believed  to 
have  its  "trophic  center"  and,  if  this  becomes  diseased, 
the  nutrition  of  the  parts  dependent  upon  it  suffers, 
causing  partial  or  complete  atrophy.  Many  obstinate 
diseases  of  the  skin  and  of  the  joints  depend  upon  disease 
of  their  nourishing  nerve-centers. 

6. — Certain  areas  of  the  nervous  system  directly  control 
and  regulate  the  circulation  of  the  blood;  this  vaso- 
motor  function  of  the  nervous  system  will  be  more  fully 
described  in  a  paragraph  on  circulation  derangements. 

7. — The  processes  of  secretion  and  excretion  are 
directly  maintained  and  regulated  by  the  nervous  system; 
this  excito-secretory  function  explains  why  the  mouth  of 
a  hungry  man  waters  at  sight  or  at  thought  of  savory 
food,  how  the  tears  well  up  under  the  stimulus  of  emotion, 
and  why  the  secretion  of  the  digestive  juices,  and  the 
consequent  appetite  and  digestion,  is  influenced  by  good 
or  bad  news,  or  why  the  skin  and  mouth  sometimes 
become  dry  and  parched  under  the  influence  of  any 
intense  emotional  excitement. 


94  THE  PHYSIOLOGY  OF  NERVE  FORCE 

8. — The  nervous  system  acts  as  a  battery  to  gen- 
erate and  give  out  force  to  every  part  where  there  are 
muscular  fibres;  the  muscles,  arteries  and  veins,  stomach 
and  bowel  walls,  and  every  organ  that  contains  muscular 
fibres,  gets  that  quality  which  we  call  tone,  from  the 
steady,  gentle  force-supply  from  the  nervous  system. 
Muscular  exertion  involves  the  expenditure  of  nerve-force, 
the  power  is  manifested  in  the  muscles,  but  it  comes  from 
the  nerve-cells,  just  as  the  power  which  is  manifested  in 
the  ringing  of  an  electric  bell  comes  from  the  cells  of  the 
galvanic  battery;  the  champion  oarsman  is  not  the  man 
with  the  largest  or  hardest  muscles,  but  he  whose  nervous 
system  can  supply  the  largest  amount  of  force  and  main- 
tain it  the  longest  in  the  race. 

9. — The  brain  receives,  assorts,  distributes  to  its  differ- 
ent parts,  and  registers,  impressions  and  sensations  from 
every  part  of  the  body,  but  although  the  brain  feels  for 
the  whole  body,  it  cannot  feel  for  itself;  surgical  operations 
upon  the  brain  tissue  cause  no  pain.  When  a  pin  is 
thrust  into  the  finger  the  pain  is  really  felt  in  the  brain; 
the  proof  being  that  if  the  nerve  which  connects  the  finger 
with  the  brain  be  cut,  the  pin  can  cause  no  pain;  the 
finger  is  numb  and  paralyzed.  The  nerves  may  be  com- 
pared to  telegraph  wires;  they  transmit  nervous  impulses 
•om,  and  impressions  to,  the  brain  and  spinal  cord. 

THE    SOURCES    OF    NERVE-FORCE 

The  power  that  is  expended  with  every  thought  and 
movement  comes  from  food  and  oxygen.  The  blood — 
liquefied  and  digested  food — circulates  through  every 
tissue  and  brings  to  every  cell  and  fibre  the  chemical 
materials  with  which  it  may  renew  itself;  it  also  brings 
oxygen  in  little  red  sacs,  which  unites  chemically  with 
the  worn-out  elements  of  the  tissues,  burns  them  up,  or 


THE  PHYSIOLOGY  OF  NERVE  FORCE  25 

oxidizes  them;  in  this  body-combustion  heat  is  evolved, 
and  this  heat,  by  a  mysterious  vital  process,  is  converted 
into  force,  with  which  every  brain  and  nerve-cell  is  more 
or  less  charged .  This  force  may  be  compared  to  electricity 
and  the  nerve-cell  to  a  I^eyden  jar. 

THE    RELATION    OF    GOOD    FOOD,    GOOD     DIGESTION     AND 
PURE    AIR   TO    NERVE  FORCE 

The  nerve-cells  may  be  starved  by  a  poor  food-supply, 
either  from  poverty  of  purse  or  of  digestive  power.  The 
evolution  and  storage  of  force  may  be  lessened  by  a  poor 
supply  of  oxygen,  as  in  those  leading  a  sedentary  life, 
taking  no  exercise,  breathing  with  only  the  upper  third  of 
the  lungs,  or  spending  a  large  portion  of  their  time  in 
furnace-heated  apartments,  or  in  other  places  where  the 
oxygen  of  the  air  is  diminished. 

THE    RELATION    OF    SLEEP    TO    NERVE  FORCE 

During  the  day  the  expenditure  of  brain  and  nerve  force 
in  thinking,  moving,  working,  is  greater  than  the  capacity 
of  the  nervous  system  to  store  it  from  the  blood,  so,  after 
sunset,  a  halt  is  called  for  sleep.  During  sleep  the  ex- 
penditure of  nerve- force  is  reduced  to  a  minimum,  and 
income  is  far  in  excess  of  out-go;  man  awakes  after  a  good 
night's  sleep  with  his  nerve-cells  charged  with  an  abun- 
dance of  force  for  the  labors  of  the  day.  Sleepless  nights 
quickly  exhaust  the  reserve  force  and  a  time  comes  when 
the  individual  must  sleep.  A  young,  strong  person 
quickly  recuperates  from  the  effects  of  prolonged  loss  of 
sleep  because  his  vigorous  young  brain  and  nerve-cells 
have  the  power  of  rapidly  absorbing  new  force;  in  the 
old  or  enfeebled  this  power  of  creating  nerve-force  is  slow, 
and  recuperation  correspondingly  so. 


26  THE  PHYSIOLOGY  OF  NERVE  FORCE 

CONSEQUENCES    OF    EXCESSIVE    NERVE-WASTE 

Thus  the  nerve-cells  are  constantly  the  seat  of  two 
processes — nerve-waste  and  nerve-repair.  When  these 
two  processes  are  proportionate  in  the  individual,  all  goes 
well.  But  when  nerve-waste  habitually,  or  for  a  time, 
exceeds  repair,  certain  changes  take  place  within  the 
nerve-cell;  it  becomes  weakened,  not  only  in  its  capacity 
to  put  out  force,  but  also  in  its  capacity  to  attract  nourish- 
ment and  create  force  from  the  blood;  it  becomes  irritable, 
over-sensitive  to  impressions,  its  power  of  enduring  is 
diminished.  When  these  two  conditions  of  weakness  and 
irritability  become  established  in  the  nerve-cells,  other 
parts  of  the  body  suffer;  the  whole  physiology  of  the 
individual  may  become  disordered,  weakened,  unsteady. 
Nervousness,  nervous  debility,  nervous  prostration  or 
exhaustion,  are  names  in  common  use  to  describe  the 
consequences  of  a  continued  predominance  of  nerve- waste 
over  nerve-repair. 


PHASES. 


THE    SYMPTOMS    OF    NERVOUS    IMPAIRMENT. 

The  signs  of  the  nervous  irritability  and  weakness 
which  result  from  excessive  nerve-waste,  or  from  the  dis- 
turbing influence  of  chronic  local  disease,  have  long  been 
known  to  physicians,  but  it  is  only  within  a  few  years 
that  the  true  import  and  relationship  of  these  symptoms 
has  come  to  be  thoroughly  comprehended. 

The  symptoms  of  nervous  impairment  have  been  col- 
lected, classified,  appraised  and  practically  created  into  a 
new  disease  known  as  Neurasthenia,  literally,  nerve- 
weakness.  This  term  has  been  more  or  less  universally 
adopted  by  progressive  physicians,  although  the  scientific 
propriety  of  grouping  all  the  varied  phases  of  nervous 
impairment  under  one  name  has  been  denied  by  some. 
As  a  fact,  the  introduction  of  Neurasthenia  as  a  new 
disease  is  at  variance  with  the  scientific  methods  of  classi- 
fication in  use,  but  in  practice  there  is  no  other  disease 
whose  natural  history  is  more  clear  and  symmetrical,  and 
none  whose  treatment  is  more  plainly  indicated. 

Various  types  of  Neurasthenia  have  been  described: 
thus,  when  the  brain  is  the  organ  chiefly  affected,  the 
term  Cerebral  Neurasthenia,  or  brain  exhaustion,  is  used, 
and  other  terms,  Spinal  Neurasthenia,  Gastric  Neuras-> 
thenia,  Sexual  Neurasthenia,  are  self-explanatory. 

It  is  not  my  purpose  to  attempt  any  elaborate  pen^ 
picture  of  the  symptoms  of  nervous  impairment,  but 
rather  to  so  explain  their  significance  that  the  chapter  on 
Remedies  may  be  as  clear  and  as  valuable  as  possible. 


•98  PHASES 

Of  the  somewhat  numerous  train  of  symptoms  follow- 
ing excessive  nerve- waste,  only  a  portion,  perhaps  only 
'one  or  two,  are  to  be  seen  in  any  single  case,  and 
although  nervous  debility  is  said  to  be  the  most  common 
disease  in  America,  it  is  seldom  that  two  patients  ever 
present  exactly  the  same  combination  of  symptoms. 

NERVOUSNESS 

Is  the  manifestation  of  a  greatei  or  less  degree  of  nerve 
weakness,  inherited  or  acquired. 

In  some  persons  any  emotional  perturbance  or  excite- 
ment, or  any  mental  effort  which  rapidly  uses  up  a  large 
amount  of  force,  leaves  the  whole  muscular  system  weak 
and  trembling,  and  periods  of  activity  and  vivacity  are 
apt  to  be  followed  by  periods  of  depression  and  wretched- 
ness; these  phenomena  indicate  the  smallness  of  the 
nervous  resources,  and  the  inconstant,  unstable  out-flow 
of  nerve-force.  So  the  intolerable  annoyance  which  some 
persons  feel  at  certain  creaking  noises,  the  sudden  starting 
at  slight,  unexpected  sounds,  the  excessive  peevishness, 
the  lack  of  self-control,  the  losing  presence  of  mind  at 
nothing — "going  all  to  pieces" — are  signs  of  the  abnor- 
mal susceptibility  and  lessened  endurance  of  the  nervous 
tissues. 

NERVOUS    PROSTRATION 

Is  an  abrupt  failure  of  the  life-forces;  it  may  be  partially 
recovered  from  in  a  few  days,  or  it  may  keep  the  patient 
hovering  between  life  and  death  for  weeks,  according  to 
the  degree  of  the  vital  over-draft. 

A  serious  case  of  nervous  prostration  is  as  impressive  a 
health  lesson  as  can  be  imagined.  The  active  man  of  a 
few  days  before  is  now  a  helpless  inert  mass;  in  his  face 
every  vestige  of  youth,  health  and  mental  power  is 
replaced  by  a  worn,  prematurely  aged  appearance  painful 


PHASES g& 

to  look  upon.  The  strong,  quick  intelligence  familiar  ta 
his  friends  is  degraded  to  a  stupid  indifference,  or  inco- 
herence; in  some  cases  visions  or  delirium  occur;  the 
pulse  beats  quickly  and  feebly,  thin  as  a  thread  under  the 
finger,  and  almost  feels  as  though  it  might  at  any  moment 
die  away  forever.  Muscular  strength  is  at  its  lowest  ebb; 
slight  exertion  causes  trembling;  the  subject  is  unable  to, 
rise,  he  is  forced  by  outraged  nature  to  permit  a  remedy 
that  was  long  ago  her  due — rest.  Fever,  persistent  sleep- 
lessness, headache,  vertigo,  congestion  of  the  brain, 
alarming  sinking  sensations  are  common  symptoms. 

In  some  cases  the  sick  man  never  reacts  from  this  col- 
lapse, but  after  lingering  for  days  or  weeks,  dies — a  real 
suicide;  but  the  larger  proportion  of  cases  slowly  respond 
to  rest,  judicious  medication  and  feeding.  A  careful 
nursing  of  the  remnants  of  life  recalls  the  subject  from 
his  graveward  course;  although,  after  passing  through 
such  an  experience,  the  patient  is  seldom  or  never  again 
the  man  he  was. 

The  acute  form  of  nervous  exhaustion  is  far  less  com- 
mon than  the  chronic,  and  it  is  to  the  description  of  the. 
various  phases  of  c 'ironic  neurasthenia  that  the  remain-, 
der  of  this  chapter  will  be  devoted. 

ALTERED    PERSONAL    APPEARANCE. 

Some  years  since  a  distinguished  English  visitor,  Her- 
bert Spencer,  in  the  course  of  a  New  York  address,  said: 

"  Everywhere  I  have  been  struck  with  the  number  of  faces 
which  told  in  strong  lines  of  the  burdens  that  had  to  be  borne.  I 
have  been  struck,  too,  with  the  large  proportion  of  gray-haired 
men,  and  inquiries  have  brought  out  the  fact,  that  with  you  the 
hair  commonly  begins  to  turn  some  ten  years  earlier  than  with  us. 
Moreover,  in  every  circle,  I  have  met  men  who  had  themselves 
suffered  from  nervous  collapse  due  to  stress  of  business,  or  named 
friends  who  had  either  killed  themselves  by  over-work,  or  had  been 
permanently  incapacitated,  or  had  wasted  long  periods  in  endeav-, 
ors  to  recover  health." 


30  PHASES 


Altered  personal  appearance  is  a  phase  of  nervous 
impairment  abundantly  illustrated  in  American  business 
and  social  life. 

Extreme  thinness,  sometimes  even  to  emaciation, 
often  occurs  because  the  fatty  tissues  are  not  sustained  by 
the  blood — the  excessive  demands  of  brain  and  nerve  lead 
them  to  appropriate  the  fat  forming  elements  of  the  blood 
for  force  creation,  and  thus  leave  little  or  none  to  be 
deposited  as  fat.  This  thinness  is  sometimes  limited  to 
certain  parts  of  the  body,  as  the  face;  in  other  cases  the 
face  remains  the  only  plump  part.  A  peculiar  sunken 
and  aged  appearance  of  the  tissues  lying  immediately 
about  the  eye  is  a  sign  which  I  have  frequently  noted  in 
victims  of  overwork  and  sexual  excesses. 

Baldness  in  a  large  proportion  of  cases  is  the  direct 
result  of  overactivity  of  the  nervous  system  in  some  form 
or  other.  The  conditions  of  healthy  hair  are:  a  blood- 
current  containing  certain  substances,  its  free  circulation 
in  the  vessels  of  the  scalp,  and  the  power  of  the  hair  fol- 
licles to  pick  up  these  substances  and  convert  them  into 
hair.  Excessive  nerve- waste  subtracts  from  the  natural 
vigor  of  the  hair  follicles;  they  become  chronically  enfee- 
bled and  lose  their  power  of  attracting  the  necessary  ele- 
ments of  the  blood-stream,  and  of  absorbing  them  and 
converting  them  jnto  hair.  Of  course,  many  other 
unsanitary  conditions  affect  the  health  of  the  hair  follicle, 
but  this  enfeeblement  of  poor  innervation,  which  results 
from  a  poor  oxygen  supply  to  the  nerve-cells,  from  exces- 
sive nerve-waste,  and  from  inheritance,  is  by  far  the  most 
common  cause  of  premature  baldness.  Baldness  is  rare 
among  those  races — as  the  Indians — to  whom  nervous- 
ness is  unknown,  and  in  women,  who  are  seldom  obliged 
to  bear  the  same  degree  of  nervous  strain  that  men  are. 
This  explains  the  inefficiency  of  all  the  popular  methods 


PHASES  31 

of  treating  baldness;  it  is  easy  to  bring  the  blood  into  the 
scalp  by  friction  or  stimulating  lotions,  but  an  enfeebled 
hair  follicle  cannot  use  this  blood,  just  as  the  dyspeptic's 
stomach  cannot  use  a  hearty  meal — we  may  lead  a  horse 
to  water  but  we  cannot  make  him  drink.  The  treatment 
of  the  baldness  of  nervous  impairment  consists  chiefly 
in  improving  the  vigor  and  resources  of  the  nervous  sys- 
tem, as  advised  in  the  following  chapter,  more  than  in  the 
use  of  local  measures. 

Brittleness  and  slow  growth  of  the  nails  is  a  condition 
probably  due  to  an  insufficiency  of  available  phosphates 
in  the  blood  after  the  requirements  of  the  brain  have  been 
met,  and  to  a  debility  of  the  central  nerve-cells  controlling 
the  nutrition  of  the  integument. 

The  firmness  of  muscle,  blood-vessel,  and  to  some 
extent  of  the  surface  flesh,  depends  upon  a  steady  stream 
of  nerve-force  from  the  nerve-cells.  When  this  is  dimin- 
ished the  tissues  may  become  lax,  more  or  less  flabby, 
the  flesh  lacks  tone,  the  veins  may  be  relaxed  and  dilated, 
and  a  general  atony  may  prevail  at  a  time  of  life  when 
the  tissues  should  be  firm  and  solid. 

But  while  the  above  remarks  are  applicable  to  many 
cases,  it  is  also  true  that  a  high  degree  of  general  nervous 
impairment  may  exist  in  persons  who  are,  to  the  casual 
observer,  the  healthiest  of  men.  This  is  most  strikingly 
exemplified  in  certain  individuals  of  a  mixed  nervo- 
sanguine  temperament,  having  fine,  thin  skins  and  plenty 
of  red  blood;  they  sometimes  are  pictures  of  rosy  health, 
their  digesting  and  blood-making  organs  being  perfect, 
while  the  nervous  system  is  weak  and  irritable  in  the 
extreme. 

AN    UNNATURAL    FATIGUE 

Is  often  for  a  time  the  only  indication  of  failing  nerve 
power.  The  accustomed  duties  of  life  become  excessively 


«2 PHASES 

irksome,  and  the  subject  experiences  a  constant  feeling  of 
weariness.  Many  persons  sleep  soundly  eight  or  even  ten 
hours,  but  arise  from  their  beds  unrefreshed,  inelastic, 
languid,  and  it  is  two  or  three  hours  before  they  become 
braced  up  for  the  duties  of  the  day.  When  this  abnormal 
tiredness  occurs  in  an  apparently  healthy  man,  he  is  apt. 
to  be  suspected  of  laziness  and  to  get  but  little  sympathy. 

MENTAL    PHASES. 

The  brain  is  the  organ  of  mind;  upon  the  physical  con- 
ditions of  the  brain-tissue  and  its  blood  supply,  largely 
depend  those  traits  and  characteristics  which  make  up  a. 
man's  individuality.  When  the  brain-cells  become  weak- 
ened by  over  use,  the  mind  may  present  certain  abnor- 
malities whose  meaning  the  physician  has  frequent  occa- 
sion to  interpret. 

Mental  Irritability  is  a  frequent  manifestation  of  the 
physical  irritability  and  weakness  within.  A  fretful, 
peevish  manner,  an  increasing  irascibility,  a  tendency  to 
become  angered  at  slight  provocation  or  without  provoca- 
tion, an  abnormal  suspiciousness  or  jealousy;  in  woman, 
an  abnormal  emotional  sensitiveness,  sometimes  approach- 
ing hysteria — these  are  trouble-creating  traits  which 
may  be  developed  in  the  most  amiable  individual  as  a 
result  of  nervous  impairment. 

These  exhibitions  are  apt  to  be  looked  upon  as  moral 
failings,  and  met  with  reproach  and  censure  when  medical 
advice  or  treatment  is  what  is  needed. 

Depression  of  Spirits  is  a  common  phase.  Poorly 
nourished  brain-cells  cannot  be  expected  to  put  forth  a 
strong,  hopeful,  joyous  quality  of  mind.  The  gloomy 
forebodings  and  the  morbid  fears  of  nervous  impairment 
become  in  some  cases  a  true  insanity,  and  may  even  lead 
to  suicide,  but  more  often  this  phase  takes  the  form  of 


PHASES 


repeated  fits  of  the  blues,  or  of  hypochondria.  In  thi:3 
latter  condition  the  subject  feels  that  he  is  sick,  and  hi:; 
attention  once  fixed  upon  his  condition,  develops  into  a 
morbid  habit  of  introspection;  he  exaggerates  the  mean- 
ing of  all  his  symptoms  and  fears  the  worst  consequences. 

Thousands  of  medical  vampires  deliberately  do  all  in 
their  power  to  cultivate  this  wretchedness,  and  derive 
large  incomes  by  playing,  upon  this  phase  of  nervous, 
impairment. 

Impairment  of  Memory.  The  process  by  which 
external  impressions  become  fixed  forever  in  the  mind  has 
been  compared  to  photography — the  highly  sensitive- 
particles  of  brain  matter  corresponding  to  the  highly  sensi- 
tized plate  in  the  camera.  Every  impression  is  brought 
to  the  brain  through  the  special  senses  of  sight,  hearing, 
taste,  touch  and  smell;  and  every  thought  and  imagina- 
tion of  the  mind  is  supposed  to  be  registered — that  is  to 
produce  certain  molecular  changes  in  the  brain-cells. 
But,  since  these  brain-cells  are  being  constantly  worn  out 
and  destroyed,  and  the  life  of  the  individual  cell  is 
transient,  how  is  it  that  this  registration  is  permanent? 
This  is  explained  by  applying  the  law  of  heredity  to  cell- 
life.  Within  every  cell  is  a  spot  or  germ,  which,  as  the 
cell  itself  is  passing  through  the  various  terms  of  its 
existence,  gradually  developes,  and  eventually  takes  the 
place  of  the  parent  cell,  canning  on  all  the  molecular 
peculiarities  of  the  parent  cell. 

The  vigor  of  the  memory  is  apt  to  be  in  direct  proper- 
portion  to  the  vigor  of  the  brain-cell.  In  youth,  memory 
is  keen,  and  many  of  the  impressions  registered  in  the 
substance  of  the  brain  during  that  period  of  life  are 
remembered  vividly  in  extreme  old  age,  while  impres- 
sions brought  to  the  comparatively  blunted  and  enfeebled 
brain-cells  of  old  age  are  forgotten  in  a  week  or  a  day. 


34 PHASES 

This  illustrates  how  it  is  that  an  enfeebled  condition  of 
the  brain-centers  is  apt  to  be  manifested  by  a  failing  mem- 
ory. The  cells,  poorly  nourished  by  thin  blood,  or 
impoverished  by  an  excessive  expenditure  of  their  reserve 
force,  become  sluggish,  blunted,  unimpressionable  at  any 
age,  just  as  they  do  in  the  natural  failing  power  of 
extreme  old  age.  Many  degrees  of  impairment  of  mem- 
ory are  met  with.  Of  course,  the  capacity  of  the  brain 
to  register  impressions  has  its  limits.  A  three  weeks' 
tour  of  Europe  is  apt  to  leave  indistinct  and  confused 
memories.  A  man  whose  business  involves  the  remem- 
brance of  a  vast  number  of  details,  may  have  a  very  poor 
memory  for  things  outside  the  range  of  that  business, 
without  having  any  degree  of  brain  or  nerve  impairment. 
Closely  related  to  this  impairment  of  memory  is  an 
Impairment  of  the  Faculty  of  Speech.  The 
power  of  speech  requires  a  more  or  less  normal  condition 
of  the  vocal  organ  in  the  throat — the  larynx,  of  the  mus- 
cles concerned  in  articulation — those  of  the  tongue  and 
lips,  and  of  the  resounding  chambers  or  cavities  in  and 
adjacent  to  the  throat  and  nose.  But,  in  addition,  it 
requires  the  more  or  less  healthful  condition  of  certain 
brain-cells,  the  speech-centers,  in  which  reside  the  faculty 
of  language,  or  that  part  of  intelligence  which  associates 
certain  words  with  certain  ideas. 

A  fluent  speaker  is  one  in  whom  the  speech-center  in 
the  brain  is,  by  heredity  or  by  cultivation,  highly  devel- 
oped. This  instinct  for  words  may  be  extraordinary  in 
persons  who  are  not  fluent  talkers;  some  of  the  most 
famous  authors  have  been  comparatively  stupid  compan- 
ions, or  have  been  totally  unable  to  make  a  speech  in 
public.  Children  born  deaf,  or  becoming  deaf  from 
early  sickness,  remain  dumb,  not  because  the  vocal  organs 
are  at  fault,  but  because  the  speech-center  in  the  brain 


PHASES  35 

cannot  be  sufficiently  educated  without  hearing.  When, 
as  a  result  of  over  brain-work,  the  vigor  of  the  cells  of 
the  .speech-center,  in  common  with  other  parts  of  the  brain, 
becomes  impaired,  the  subject  may  be  noticed  to  fre- 
quently misuse  words,  or  syllables,  or  even  single  letters, 
generally  the  initial  letter  of  words;  and  he  may  be  often 
at  a  loss  for  a  familiar  word.  This  impaired  fluency  of 
speech  is  not  constant;  the  individual  may  be  a  strong 
and  eloquent  speaker  under  the  stimulus  of  certain  sur- 
roundings, but  in  his  enervated,  listless  moments,  when 
the  brain  is  more  or  less  off  duty,  this  phase  may  be  very 
conspicuous. 

Impairment  of  Will  Power.  Volition  is  the  rarest 
and  most  valuable  quality  of  mind.  There  are  a  hun- 
dred men  who  are  wise  for  one  who  is  strong,  and  the 
man  with  a  strong  will  is  apt  to  control  his  fellows.  In 
many  cases  of  nervous  impairment,  weakening  of  the 
will  power  is  very  noticeable.  A  patient  lately  informed 
me  that  he  had  left  home  immediately  after  breakfast  to 
have  an  aching  tooth  drawn,  but,  though  be  had  fully 
decided  that  the  tooth  must  be  removed,  he  could  not 
bring  himself  to  enter  the  dentist's  office;  he  passed  and 
repassed  the  door  innumerable  times,  and  it  was  noon 
before  he  could  force  himself  to  enter  and  submit  to  the 
momentary  operation.  This  incident  by  itself  is  not 
proof  of  an  impaired  will,  but  when  such  a  peculiarity 
developes,  as  it  did  in  this  case,  in  a  man  to  whose  known 
character  it  is  utterly  foreign,  then  it  is  so.  My  patient 
had  visited  the  dentist  many  times  before  without  shrink- 
ing, and  his  acquired  enfeeblement  of  will  was  manifested 
in  other  directions.  Fickleness,  inconstancy,  wavering, 
an  inability  to  concentrate  the  mind,  or  to  long  apply  it 
to  study  or  work,  are  often  the  manifestations  of  an 
acquired  enfeeblement  of  will,  and  may  seriously  affect 


36  PHASES 

the  business  or  social  interests  of  the  individual.  The 
patriarch's  "Unstable  as  water,  thou  shalt  not  excel" 
well  describes  some  of  these  cases.  This  impairment  of 
will  power  is  not  unfrequently  exhibited  in  old  and 
wealthy  families  where  the  stock  is  retrograding  from  a 
lack  of  earnest  work  combined  with  dissipation,  and  it  is 
one  of  the  serious  consequences  of  several  of  the  drug 
habits,  notably  of  morphine  and  of  chloral  addiction. 

CIRCULATION  DERANGEMENTS 

The  vessels,  by  means  of  which  the  blood  circulates 
through  every  part  of  the  body,  are  not  rigid  and  unyield- 
ing tubes,  but  have  the  property  of  dilating  and  contract- 
ing. These  changes  of  calibre  occur  under  a  great  variety 
of  circumstances.  In  the  moment  of  sudden  fear  the  blood 
recedes  from  the  skin  and  rallies  around  the  vital  organs 
within  as  if  to  protect  them — the  face  is  ' '  blanched  with 
terror ' ' ;  under  the  stimulus  of  another  emotion  the  ves- 
sels of  the  skin  dilate,  and  the  blood  rushing  in  to  fill 
them  causes  the  blush  of  shame;  when  the  body  is 
exposed  to  cold,  the  blood-vessels  of  the  skin  contract  and 
the  blood  is  partially  withdrawn  from  the  surface,  in  order 
that  it  may  be  kept  hot  and  not  radiate  its  heat  too  rapidly 
into  the  cold  air;  under  the  influence  of  heat  the  blood  is 
led  into  the  skin,  that,  by  radiation  and  by  evaporation 
of  sweat,  the  body  may  lose  part  of  its  superfluous  heat; 
during  study  or  earnest  thought  the  blood-wave  is 
attracted  to  the  brain;  during  and  after  digestion  to  the 
stomach  and  other  digestive  organs. 

The  duty  of  managing  these  complicated  circulation 
changes  belongs  to  a  certain  part  of  the  nervous  system  of 
organs  known  as  the  vaso-motor  system.  This  system 
consists  of  central  collections  of  nerve-cells  and  of  innu- 
merable thread-like  nerves  which  run  along  in  the  walls  of 


PHASES  37 


every  blood-vessel  in  the  body.  In  health  all  goes  well, 
but  when  the  nerve-cells  of  the  central  nervous  system 
become  weakened  or  irritable,  the  action  of  the  dependent 
*vaso~motor  nerves  is  apt  to  become  deranged  and  unsteady, 
the  abnormally  susceptible  blood- tubes  are  not  properly 
controlled,  and  certain  circulation  derangements  result. 
One  of  the  most  common  of  these  is:  Partial  Congestion 
of  the  Brain.  Brain  exercise  attracts  a  large  quantity  of 
blood  into  the  brain- vessels,  which,  when  the  brain  exer- 
cise is  at  an  end,  should  be  made  to  recede  from  the  brain 
by  the  contraction  of  the  blood-vessels;  but  if  the  supply 
of  nerve -force  to  these  blood-vessels  is  insufficient,  they 
are  sluggish,  lack  tone,  and  cannot  contract;  the  brain 
remains  engorged  with  blood,  and  we  may  have  a  Congest- 
ive Headache  or  perhaps  a  persistent  Sleeplessness.  Or, 
the  blood-flow  to  the  brain  may  be  too  small,  causing  Anae- 
mic Headache,  vertigo  or  dizziness,  and  a  variety  of 
sensations  referable  to  the  head,  eyes,  and  ears.  The 
Excessive  Blushijtg  which  so  annoys  some  patients,  and 
the  hot  flashes  experienced  by  many  women  about  the 
change  of  life,  are  examples  of  this  unsteadiness  of  the 
circulation  resulting  from  a  weakened,  or  an  irritated 
nervous  system. 

There  may  be  constant  coldness  of  the  feet  and 
hands,  or,  on  the  other  hand,  the  extremities  may  be 
warm  and  perspiring,  according  as  the  blood  current  is 
over  or  under  the  normal  supply  to  these  parts.  Almost 
any  organ  in  the  body  may  be  affected  by  these  irregular- 
ities of  blood-supply.  A  congested  and  abnormally  sen- 
sitive condition  of  the  spinal  cord,  with  or  without  some 
disorder  of  the  reproductive  organs,  is  a  common  symptom 
among  women,  known  as  Spinal  Irritation,  or  the  Irri- 
table Spine;  The  Irritable  Ovary  and  the  Irritable  Ute- 
rus are  terms  which  imply  an  irritable,  congested  and 


88  PHASES 

relaxed  condition  in  those  organs.  In  the  male  a  relaxed, 
congested  and  hyper-sensitive  state  of  certain  deep-seated 
parts — the  urethra,  the  prostrate  gland,  and  parts  adja- 
cent— are  often  the  conditions  keeping  up  Spermatorrhcea 
and  Impolency.  One  form  of  weak  and  Irritable  Kyes  de- 
pends upon  a  state  of  chronic  congestion  in  the  mucous 
membrane  of  the  eye — the  conjunctiva. 

DISORDER    OF    SECRETION    AND     EXCRETION 

The  skin  contains  immense  numbers  of  sweat-glands 
whose  function  it  is  to  excrete,  or  separate  from  the 
blood,  certain  waste  substances  in  solution;  so,  too,  the 
pink,  shining  mucous  membrane  lining  those  cavities  of 
the  body  which  communicate  with  the  air,  and  which  is 
a  kind  of  internal  skin,  is  studded  with  innumerable  fol- 
licles which  secrete,  or  separate  from  the  blood,  a  thin 
fluid  mucus.  This  mucus  serves  to  protect  the  parts,  to 
keep  them  moist  and  flexible,  and,  by  being  constantly 
removed  and  changed,  it  keeps  the  parts  clean.  Both 
these  sets  of  glands  are  under  the  direct  influence  of 
certain  nerve-cells,  and  in  nervous  impairment,  this 
excito-secretory  office  of  the  nervous  system  may  become 
disordered,  unsteady,  over  or  under  the  normal  degree  of 
activity,  causing  Excessive  Perspiration  of  the  hands 
or  feet,  or  of  the  whole  body;  or  in  other  cases  an  Un- 
natural Dryness  of  the  Skin,  or  an  Abnormal  Dryness  of 
the  Mouth  and  Throat. 

THE    IRRITABLE    HEART 

Palpitation  of  the  heart  is  one  of  the  most  common 
symptoms  of  nervous  debility,  and  one  which  sometimes 
causes  much  uneasiness  or  alarm.  The  heart  is  a  hollow 
muscle,  swung  somewhat  freely  in  the  chest,  whose  busi- 
ness it  is  to  keep  the  blood  in  motion.  It  acts  as  a  pump, 


PHASES  39 

receiving  the  dark  blood  from  the  veins  and  forcing  it 
into  the  lungs,  where  it  is  purified  and  reddened  by  con- 
tact with  oxygen;  then  it  again  receives  this  red  oxygen- 
laden  blood  from  the  lungs  and  pumps  it  to  every  organ 
and  tissue,  through  hundreds  of  elastic  tubes, — the  arteries. 

The  power  or  force  that  keeps  the  heart  moving,  day 
and  night,  comes  from  the  nervous  system,  just  as  the 
force  that  vibrates  the  hammer  of  an  electric  bell  comes 
from  the  galvanic  battery.  While  this  supply  of  nerve 
force  flows  out  to  the  muscular  fibres  of  the  heart  in 
proper  quantity,  that  organ  beats  strongly,  steadily,  and 
with  a  certain  rhythm.  But  if  the  nerve-cells,  or  batteries, 
of  the  nervous  system,  become  weakened  by  over-expen- 
diture, two  things  may  happen:  first,  the  nerve-cells  can- 
not give  out  a  strong  current  of  force  to  properly  main- 
tain the  beating  of  the  heart;  second,  one  certain  nerve, 
whose  duty  it  is  to  maintain  the  rhythm  of  the  heart,  by 
keeping  it  to  a  certain  number  of  beats  per  minute,  par- 
tially loses  its  governing  power,  and  becomes  more  or  less 
unreliable.  These  two  conditions  of  nerve  weakness 
cause  palpitation  of  the  heart, — a  weak  action  of  the 
heart  because  of  a  feeble  out-flow  of  nerve  force,  and  a 
rapid,  irregular  action  because  of  the  inability  of  the 
pneumogastric  nerve  to  properly  do  its  duty.  Palpitation 
of  the  heart  in  the  great  majority  of  cases,  is  not  a 
symptom  of  heart-disease,  as  that  term  is  used  by  medical 
men;  it  is  not,  in  itself,  dangerous  to  life,  and  never 
results  in  or  causes  sudden  death. 

I  have  met  men  and  women  suffering  from  this  symp- 
tom, who  firmly  believed  themselves  to  be  the  victims  of 
heart-disease,  and  over  whose  heads  the  fear  of  sudden 
death  had  hung  for  months  or  years.  They  had  obtained 
this  idea  from  the  representations  of  some  patent  medicine 
advertisement,  or  from  the  statement  of  some  ignorant  or 


PHASES 


unscrupulous  physician.  It  is  a  sad  fact  that  there  are  men, 
v/ho,  in  order  to  extort  a  petty  sum,  will  subject  a  fellow 
Luman  being  to  a  mental  misery  which  may  endure  as 
1 3ng  as  life  itself.  There  is  no  more  terrible  news  to  hear, 
r.nd  no  heavier  burden  for  the  sick  to  bear,  than  the  con- 
viction that  they  have  incurable  disease  of  the  heart. 
Palpitation  of  the  heart  is  cured  by  gradually  building  up 
the  nervous  system,  and  by  the  use  of  medicines  having  a 
direct  tonic  action  upon  the  heart,  of  which  medical 
science  has  several  of  great  value. 

REFLEX    ACTION    AND    THE    PART    IT    PLAYS 

A  principle  known  as  reflex  action  plays  an  important 
role  in  nervous  impairment,  as  it  does  in  many  other  dis- 
<  rders.  The  central  cells  of  the  brain  and  spinal  cord  are 
constantly  giving  out  force,  nervous  impulses,  along  the 
conducting  nerves  to  every  part  of  the  body,  and  as  con- 
stantly receiving  impressions  from  every  part  by  means  of 
other  nerve-fibres.  The  healthy  nutrition  and  action  of 
r.ny  part  depends  largely  upon  the  health  of  the  particular 
verve-centers  in  the  spine  or  brain  which  controls  it.  A 
diseased  condition  or  irritation  in  one  part  of  the  body 
nay  produce  disease  in  some  other  remote  part  by  being 
reflected  to  the  nerve-centers  which  are  related  to  both. 
Thus,  every  form  of  convulsive  functional  nervous  disease, 
as  epilepsy,  St.  Virus'  dance,  lock-jaw,  etc.,  may  result 
from  a  seemingly  trivial  irritation  in  some  remote  organ. 

The  irritating  impression  of  a  tight  foreskin  is  a  not 
rare  cause  of  convulsions  or  paralysis  in  children;  the  ir- 
ritations of  teething,  worms,  and  indigestible  food  often 
cause  convulsions  in  infants.  The  irritating  presence  of 
dried  secretions  in  the  nose  or  throat,  reflected  to  the 
nerve-centers,  is  a  common  cause  of  asthma,  hay-fever,  or 
deafness.  Constant  pain  in  the  back  often  results  from 


PHASES  41 


some  abnormal  condition  in  the  womb,  or  in  the  rectum. 
Persistent  epilepsy  may  result  from  constipation,  from 
hardened  wax  in  the  ears,  from  eye  or  ear  strains,  and 
from  many  other  reflex  irritations.  The  first  thing  an 
expert  in  nervous  diseases  does  with  a  new  case  of  "fits," 
of  which  the  cause  is  not  obvious,  is  to  overhaul  the  pa- 
tient from  head  to  heel  in  the  search  for  possible  sources 
of  reflex  irritation.  When  the  circulation  derangements 
described  above  establish  irritable  and  congested  ovaries, 
spine,  or  prostate  gland,  a  continuous  morbid  impression 
is  reflected  to  the  central  nervous  system,  which  is  thus 
harassed,  irritated  and  weakened.  There  is  an  intimate 
relation  between  the  digestive  organs,  as  well  as  the  repro- 
ductive organs  oi  either  sex,  and  the  brain,  and  hence  it  is 
that  any  chronic,  continuously  acting  irritation  in  those 
parts  exerts  a  most  depressing  influence,  not  only  upon 
their  own  centers  of  nutrition,  but  also  upon  the  brain 
and  mind  itself,  causing  melancholia,  hypochondriasis 
and  other  depressed  forms  of  mental  aberration. 

HEADACHES    AND    VARIOUS    HEAD  SENSATIONS 

There  is  a  great  variety  of  headaches  and  of  causes  of 
headaches,  and  a  book  much  larger  than  this  might  be 
devoted  to  this  symptom  alone.  Thus,  headache  may  be 
the  result  of  exposure  to  cold,  of  dyspepsia,  of  heart  dis- 
ease, of  disease  of  the  brain,  or  of  eye  and  ear  strains.  It 
may  also  occur  when  the  blood  is  loaded  with  unnatural 
substances;  a  large  dose  of  quinine  often  causes  headache, 
and  the  blood-poisoning  of  Bright' s  disease  gives  rise  to 
terrible  head-pains. 

Weakness  and  irritability  of  the  central  nerve-cells  causes 
a  variety  of  headaches  and  head  sensations:  i,  by  result- 
ing in  the  circulation  derangements  described  above,  in- 
ducing congestion  or  anemia  of  the  brain;  2,  by  rendering 


42  PHASES 

the  brain-tissue  over-sensitive  to  various  irritations  in 
other  parts  of  the  body.  The  headaches  of  nervous  de- 
bility are  described  by  patients  as  a  feeling  of  fullness,  or 
a  tight,  band-like  feeling  about  the  temples,  or  a  heavy, 
tender  feeling  at  the  crown  of  the  head,  or  in  the  back  of 
the  neck. 

Vertigo  or  dizziness  may  occur  with  or  without  some 
form  of  circulatory  derangement. 

Migraine,  or  sick  headache,  occurs  in  neurotic  persons, 
and  the  super-sensitiveness  of  the  brain-cells,  which  is  at 
the  bottom  of  it,  generally  represents  some  degree  of  ner- 
vous weakness  or  irritation. 

NEURALGIA  AND  CERTAIN  UNPLEASANT  SENSATIONS 

Neuralgia  has  been  graphically  called  ' '  the  prayer  of  a 
starved  nerve  for  food, ' '  but  it  is  not  always  so.  Like 
headache,  neuralgia  has  a  variety  of  causes.  Among  the 
most  common  of  these  are  exposure  to  cold,  causing  con- 
gestion and  pressure  about  the  nerve,  and  reflected  irrita- 
tion, as  when  a  decayed  tooth  lights  up  a  neuralgia  of  the 
whole  face.  When  the  nerve-tissues  are  overworked  and 
imperfectly  nourished,  they  become  more  sensitive  to  cold 
and  to  reflected  irritations,  and  may  ache  without  any 
apparent  exciting  cause  whatever.  The  neuralgias  of 
nervous  debility  may  occur  in  any  nerve,  but  are  most 
common  in  the  face  and  head,  and  in  the  leg. 

Certain  other  neuralgic  sensations  are  described  by  pa- 
tients. A  common  complaint  is  of  a  sore,  tender  feeling 
1 '  deep  in  ' '  any  part  of  the  spine,  sometimes  located  in 
the  back  of  the  neck,  or  a  little  lower,  between  the  shoul- 
ders; in  others  it  is  felt  in  the  loins.  This  dull  ache  in 
the  spine  indicates  that  the  spinal  cord,  at  the  point  of 
the  pain,  is  in  a  state  of  irritability  and  weakness,  and  of 
partial  congestion. 


PHASES  43 

Quite  a  variety  of  peculiar  sensations  are  described  by 
different  patients,  such  as  shooting  pains  in  the  back  or 
limbs,  tenderness  in  the  scalp,  or  in  the  teeth  and  gums, 
or  at  almost  any  point;  sometimes  there  are  periods  of 
intense  itching  of  the  skin,  or  creeping  or  crawling  sensa- 
tions on  the  surface. 

There  may  be  a  dull,  aching  feeling  along  the  course  of 
the  nerves  of  the  arm  or  leg,  not  amounting  to  actual 
pain,  or  a  feeling  of  numbness  may  be  experienced  in 
some  part.  Patients  are  sometimes  uneasy  or  alarmed  at 
these  limb  sensations,  supposing  them  to  be  forerunners  of 
paralysis;  these  fears  are  groundless.  These  sensations 
merely  indicate  an  impoverished  state  of  the  nerve,  and 
are  never  followed  by  paralysis;  electricity  often  removes 
these  symptoms,  as  well  as  the  tenderness  of  the  spine,  as 
if  by  magic,  and  the  neuralgias  of  nervous  impairment 
are  often  quickly  cured,  or  greatly  benefited  by  proper 
treatment — by  electricity,  tonics,  and  attention  to  the  hy- 
gienic measures  described  in  the  chapter  on  Remedies. 

CRIPPLED    FUNCTIONS 

Certain  organs  of  the  body  may  become  crippled  in  two 
ways:  first,  by  the  prolonged  over-use  of  the  organs  them- 
selves; second,  by  being  regularly  robbed  of  their  proper 
supply  of  nerve-force  by  some  other  part.  The  organs 
which  most  frequently  suffer  are  the  digestive  and  the  re- 
productive, because  of  the  large  quantity  of  nerve-force 
which  they  require  to  fulfil  their  complicated  functions. 

Most  men  and  women  have  some  part  that  is,  by  inher- 
itance or  by  acquisition,  weaker  than  the  others;  it  is 
their  vulnerable  point.  In  one  it  is  the  stomach,  in  an- 
other the  air-passages,  in  another  the  kidneys.  When 
excessive  brain  or  muscle  work  uses  up  a  disproportionate 
amount  of  the  available  nerve  force,  the  supply  is  not 


44  PHASES 


sufficient  to  go  round,  and  the  weak  part  is  apt  to  suffer. 

IMPAIRMENTS    OF    THE    MUSCULAR    SYSTEM 

Writer's  Cramp,  or  Writer's  Palsy,  affords  a  striking 
example  of  the  exhaustion  of  certain  groups  of  nerve-cells, 
whose  capacity  for  supplying  nerve-force  has  been  over- 
drawn. It  occurs  in  penmen,  telegraphers,  pianists,  en- 
gravers, and  others  who  habitually  use  one  set  of  muscles 
to  do  more  or  less  fine  work.  The  patient  either  partially 
or  completely  loses  the  ability  to  make  the  familiar  move- 
ments of  his  craft,  while  in  other  directions  the  limb  is 
not  injured.  Thus,  the  penman  may  become  unable  to 
even  grasp  his  pen,  much  less  to  write,  while  his  power 
to  play  ball  or  perform  on  the  piano  may  remain  as  good 
as  ever.  The  cell  combination  in  the  nervous  system 
which  directs  the  complex  act  is  exhausted. 

Trembling  hands,  a  sudden  twitching  or  starting  of  the 
muscles  of  one  limb,  or  of  the  entire  body,  generally  on 
going  to  sleep,  and  a  twitching  of  the  muscles  about  the 
eyelids  on  using  the  eyes  in  reading,  or  in  any  fine  work, 
are  symptoms  that  are  frequently  described;  they  indicate 
the  unsteady,  intermittent  character  of  the  nerve  current 
which  the  muscles  receive  from  the  nervous  system. 
Subjects  of  chronic  nervous  impairment  are  not  generally 
able  to  put  out  a  large  amount  of  muscular  force  at  once, 
though  they  may  do  light  work  all  day.  I  remember  the 
case  of  a  neurasthenic  boy,  who  was  assisting  his  father 
to  carry  a  rather  heavy  plank;  he  struggled  to  maintain 
his  end^  but  suddenly  became  white  as  death,  dropped 
insensible,  and  it  was  some  time  before  he  recovered  from 
a  condition  approaching  collapse.  In  some  professional 
athletes,  great  thinness  of  face,  trembling  fingers,  palpita- 
tions, indicate  that  the  powerful  muscles  have  been  built 
up  at  the  expense  of  the  nervous  and  digestive  systems. 


PHASES  45 


Disorders  of  vision  are  frequently  met  with  in  neuras- 
thenic patients.  I  have  already  mentioned  that  the 
mucous  membrane  of  the  eye — the  conjunctiva — may 
become  red,  congested  and  watery  as  one  of  the  results  of  a 
disordered  circulation.  Weak  sight  may  be  due  to  an 
irritation  or  weakness  of  the  optic  nerve,  either  as  a 
result  of  reflex  irritation  or  of  the  irritation  of  the  visual 
nerve-centers  in  the  brain;  the  excessive  use  of  tobacco 
or  alcohol  is  one  of  the  common  exciting  causes  of  this 
condition. 

Sometimes  the  muscles  of  the  orbit,  which  control  the 
movements  of  the  eye-ball,  become  weakened,  and,  as  a 
result  of  the  lack  of  correspondence  between  these  and 
the  internal  accommodating  muscles  of  the  eye,  a  constant 
eye-strain  is  induced;  these  cases  are  not  generally  relieved 
by  glasses,  and  the  sight  may  become  so  weak  that  it  is  im- 
possible to  use  the  eyes  in  reading  for  more  than  a  few 
minutes  at  a  time.  These  eye-strains  may,  in  their  turn, 
be  the  cause  of  persistent  headaches  or  even  of  epilepsy. 

The  specks,  black  spots  or  wavy  lines  floating  before 
the  eyes,  as  well  as  the  momentary  blindness  sometimes 
described  by  nervous  patients  are  simply  indications  of  a 
general  or  local  nerve  weakness. 

An  unnatural  dilatation  of  the  pupils  of  the  eye  is 
sometimes  noticeable  in  nervous  impairment. 

Ringing,  buzzing  or  tapping  sounds  in  the  ears  are 
symptoms  occasionally  described;  one  of  my  patients  in- 
formed me  that  she  had  hardly  been  free  from  a  ringing 
in  her  ears  for  over  a  year;  at  first,  as  she  said,  it  almost 
drove  her  crazy,  but  she  finally  became  more  or  less 
accustomed  to  it. 

Perversions  of   the  sense  of  taste  and  of  smell  may 


46  PHASES 

result  from  the  disturbance  of  the  nerves  or  nerve-centers 
connected  with  these  parts;  the  individual  may  be  annoyed 
by  unnatural  odors  or  tastes,  or  the  acuteness  of  these 
senses  may  be  diminished. 

WEAKNESS    AND    ALTERATION    OF    THE    VOICE 

The  voice  may  be  temporarily  weakened  in  acute 
nervous  prostration;  in  chronic  nervous  impairment  it 
may  become  permanently  altered.  A  huskiness  or  hoarse- 
ness, a  soft  quality,  a  lack  of  timbre  and  of  power  make 
up  what  is  called  the  neurasthenic  voice.  This  altered 
voice  is  caused  by  a  flabbiness  or  lack  of  tone  in  the 
vocal  cords  and  adjacent  muscles,  and  sometimes  by  a 
relaxed,  congested  state  of  the  mucous  lining  of  the 
larynx;  the  nerves  which  run  to  these  muscles,  as  well  as 
the  nerve-centers  or  batteries  in  the  brain,  which  supply 
them  with  force,  are  in  a  state  of  chronic  depression, 
either  as  a  part  of  a  condition  of  general  brain  depres- 
sion, or  as  the  result  of  a  persistent  reflex  irritation  from 
the  stomach,  reproductive  organs  or  elsewhere. 

These  cases  are  sometimes  treated  for  chronic  laryn- 
gitis, or  some  other  condition  of  the  larynx,  but  local 
treatment  alone  never  permanently  relieves  it.  It  may 
seem  strange  to  treat  a  husky  voice  by  medicating  the 
stomach  or  womb,  but  as  I  write  I  recall  a  case  of  per- 
sistent huskiness  of  voice  in  a  young  lady  which  com- 
pletely disappeared  as  soon  as  a  displacement  of  the  womb 
was  cured;  she  had  been  a  fine  singer  and  her  husband 
had  spent  considerable  money  upon  specialists  in  diseases 
of  the  throat  without  any  great  benefit. 

NERVOUS    INDIGESTION 

The  conditions  of  good  digestion,  are:  i,  a  certain 
amount  of  tone  in  the  muscular  wall  of  the  stomach  and 


PHASES  47 


bowels;  2,  a  sufficient  secretion,  by  innumerable  glands, 
of  certain  digestive  juices,  of  a  proper  quality.  The 
power  which  preserves  this  muscular  tone  and  which  ex- 
cites these  digestive  secretions,  comes  straight  from  the 
nervous  system,  whence  it  is  conducted  by  various 
important  nerves.  That  portion  of  the  nervous  system 
which  directly  supplies  the  vital  (breathing,  circulating 
and  digestive)  organs  with  power  is  placed,  for  protection 
and  convenience,  in  the  great  cavities  of  the  chest  and 
abdomen;  here  the  nerve  cells  and  centers,  with  their 
connecting  nerves,  form  a  double  chain  in  front  of  the 
spine  extending  from  the  neck  to  the  pelvis.  This  part 
of  the  nervous  system  is  known  as  The  Great  Sympa- 
thetic; it  is  independent  of  the  will,  is  on  duty  day  and 
night,  and  its  nerve-cells  are  kept  constantly  charged 
with  vital  power  by  the  influence  of  the  central  nervous 
system;  thus  they  act  as  reservoirs  of  nerve-force. 

The  sympathetic  nervous  system  is  intimately  con- 
nected with  the  central  nervous  system  in  the  brain  and 
spine,  and  disorders  of  digestive  or  reproductive  organs 
often  produce  great  depression  of  mind. 

When  the  brain  or  muscles  are  over-worked,  the 
nervous  allowance  of  the  great  sympathetic  system  is 
reduced,  and  the  digestive  organs  are  particularly  liable 
to  suffer  from  this  insufficiency.  After  a  day  of  severe 
toil  a  man  may  be  ' c  too  tired  to  eat, ' '  which  means  that 
his  nerve-force  has  been  over-drawn,  and  that  the  stom- 
ach, lacking  its  accustomed  stimulus,  does  not  secrete  its 
juices — feels  no  appetite.  The  excito-secretory  function 
of  the  nervous  system  is  powerfully  affected  by  mental 
influence;  when  any  intense  emotion,  as  terror  or  anger, 
or  any  great  excitement  rapidly  uses  up  a  great  amount 
of  force,  the  digestive  secretions  may  be  almost  suspended 
for  hours  or  even  for  days. 


PHASES 


A  hearty  meal  eaten  after  a  day  of  hard  mental  or 
muscular  labor  is  apt  to  be  slowly  and  with  difficulty 
digested  by  the  enfeebled  stomach.  With  many  habitu- 
ally over-worked  men,  the  evening  meal  is  the  only 
hearty  one  of  the  day,  and  is  eaten  at  a  time  when  the 
digestive  organs  are  poorly  prepared  to  manage  it.  When 
a  condition  of  chronic  dyspepsia  becomes  established,  the 
nervous  system  suffers  still  further  from  the  impoverished 
blood  supply  which  the  weakened  digestive  organs  are 
able  to  prepare. 

In  some  over-worked  men  the  digestion  remains  pretty 
good,  but  is  liable  to  sudden  break-downs.  Some  day> 
without  any  apparent  cause,  the  individual  has  an  attack 
of  acute  indigestion;  his  dinner  rests  like  a  bar  of  lead 
upon  his  stomach,  or  sour  risings,  heartburn  and  belch- 
ings  plainly  indicate  that  the  meal  is  being  slowly  and 
imperfectl}'  digested. 

Or  the  victim  may  be  seized  in  the  night  with  a  violent 
colic;  the  intestinal  gases,  which  are  always  present  in 
larger  quantity  during  and  after  slow  digestion,  accumu- 
late in  the  bowel,  and  the  tired,  relaxed  bowel-wall  has. 
not  the  tone  to  contract  upon  them,  move  them  along, 
and  properly  distribute  then  in  the  intestine.  The  uncer- 
tainty of  himself,  which  the  patient  feels  in  these  cases,  is 
a  source  of  uneasiness  to  him;  he  never  knows  when  to 
expect  these  break-downs,  and  no  amount  of  dietary  care 
will  always  protect  him  from  them. 

L,ocal  treatment  with  tonics,  stimulants  and  sedatives, 
fails  to  cure;  the  bottom,  of  the  trouble  lies  deeper  than  the 
stomach,  and  before  he  can  afford  these  patients  perma- 
nent benefit,  the  physician  must  begin  at  the  foundation. 
Of  all  the  remedies  used  against  nervous  indigestion, 
drugs  are  the  least  important. 

A  French  physician,   M.  Glenard,  has  lately  described. 


PHASES  49 


a  peculiar  condition  which  I  have  noted.  He  gives  it  the 
name  Enteroptose,  which  means  ' '  a  falling  of  the  bowels. ' ' 
In  this  condition  the  contents  of  the  abdomen  are  not 
firmly  supported,  but  drag  upon  their  ligaments.  The 
changed  position  of  the  parts  which  thus  results  gives 
rise  to  changes  in  the  calibre  of  both  stomach  and  in- 
testines— dilatations  and  constrictions  occur  at  various 
points  which  interfere  with  the  proper  performance  of  the 
digestive  function. 

This  condition  may  affect  the  entire  abdominal  mass, 
but  M.  Glenard  reports  that  the  most  frequent  form  of  en- 
teroptosis  is  a  displacement  or  falling  of  the  right  arch  of 
the  large  intestine.  This  arch  normally  lies  at  a  point  in 
the  abdomen  just  to  the  right  and  a  little  above  the  navel, 
and  helps  to  support  the  stomach  above,  and  when  it  be- 
comes prolapsed  the  stomach,  in  its  turn,  sinks,  drags  and 
is  weakened. 

Of  the  three  coats  or  layers  which  make  up  the  stomach 
and  bowel  walls,  the  middle  one  is  composed  of  con- 
tractile muscular  fibres,  and  by  the  elasticity  and  resili- 
ency of  these  muscular  fibres,  the  shape  and  tone  of  these 
organs  is  maintained;  as  has  been  explained,  this  muscu- 
lar tone  depends  directly  upon  a  steady  supply  of  nerve 
force  from  the  cells  of  the  sympathetic  nervous  system. 
When  the  force-creating  and  force-supplying  capacity  of 
these  cells  is  impaired,  the  muscular  coat  of  the  stomach 
loses  tone,  becomes  more  or  less  relaxed;  the  gases  of 
slow  digestion  distend  it,  the  subject  describes  his  stom- 
ach as  "bloating."  This  gastro-ectasis,  as  it  is  called, 
may  occur  without  any  degree  of  prolapse  or  falling  of 
the  parts. 

Dr.  Fothergill,  of  lyondon,  has  lately  called  attention 
to  a  variety  of  nervous  indigestion  peculiar  to  women. 
The  intimate  relation  between  the  female  reproductive 


50  PHASES 


organs  and  the  stomach  is  well  known,  and  the  vomiting 
of  pregnancy  is  a  familiar  illustration  of  this  s}Tnpathy. 

In  Dr.  Fothergill's  cases,  persistent  dyspepsia  was  as- 
sociated with  some  morbid  condition  of  the  pelvic  organs, 
as  a  diseased  ovary  or  womb.  No  amount  of  skillful 
treatment  of  the  stomach  alone  would  effect  a  cure,  but 
when  the  trouble  in  the  reproductive  system  was  alle- 
viated, the  dyspepsia  disappeared.  This  he  calls  '  'reflex 
indigestion,"  and  it  is  explained  by  the  morbid  influence 
of  the  local  disease,  acting  upon  and  through  the  nervous 
system. 

Neuralgia  of  the  stomach  or  bowels  is  sometimes  met 
with  in  nervous  persons  as  one  of  the  symptoms  of  a 
general  over  sensibility  of  the  nervous  tissues. 

THE     RELATION     OF     NERVOUS     DEBILITY     TO     DISEASES 
OF  WOMEN 

When  the  central  nervous  system  becomes  weakened, 
the  reproductive  organs  may  become  implicated  as  a  direct 
result  of  this  condition.  In  woman  the  tone  of  these 
parts  largely  depends  upon  the  general  health.  The  ill- 
regulated,  unsteady  circulation  of  the  blood,  which  so 
often  accompanies  failure  of  nerve  power,  is  very  apt  to 
include  a  congested  and  supersensitive  state  of  certain 
organs  as  one  of  its  manifestations.  This  abnormal  condi- 
tion is  usually  found  in  the  spine,  the  ovary,  or  the 
womb,  or  in  all  three,  and — at  least  in  the  two  last-men- 
tioned organs — it  may  develop  into  a  real  chronic  inflam- 
mation. In  these  cases  the  Irritable  Spine,  the  Irritable 
Ovary  and  the  Irritable  Womb  are  not  distinct  diseases, 
but  only  the  local  symptoms  of  a  condition  of  general 
nervous  impairment.  I/ocal  treatment  alone,  however 
skillful,  cannot  effect  a  cure,  but  must  go  hand  in  hand 
with  remedies  addressed  to  the  nervous  system. 


PHASES  51 


In  over-worked  girls  menstruation  may  be  entirely 
suppressed  for  considerable  periods  as  a  result  of  the  local 
debility  thus  induced.  In  a  class  of  114  young  women 
who  were  studying  mid-wifery,  Prof.  Schroeder  found 
that  65  were  affected  in  this  manner.  In  most  of  these 
casej  the  menstrual  flow  ceased  soon  after  beginning  the 
course  of  study. 

There  is  another  class  of  cases  in  which  chronic  dis- 
orders of  the  female  reproductive  organs  are  direct  causes 
of  nervous  debility.  These  local  conditions,  often  con- 
tinued through  months  and  years,  exert  a  powerful  de- 
pression and  irritating  influence  upon  a  susceptible 
nervous  system,  just  as  a  splinter  in  the  foot  may,  by  its 
disturbing  influence,  cripple  the  entire  leg.  I  have  indi- 
cated above  how  a  local  disorder  in  the  female,  acting 
through  the  nervous  system,  may  cause  obstinate  dys- 
pepsia, which  remains  uncured  until  the  local  causative 
condition  is  rectified;  and  a  tender  ovary,  or  a  bent  and 
displaced  womb  may  so  harass  the  nervous  tissues,  as  to 
eventually  produce  all  the  symptoms  of  chronic  nervous 
impairment.  Hysteria  and  the  exaggerated  emotional 
phenomena  so  common  among  delicately  reared  women 
are  generally  the  effect  of  an  abnormally  sensitive  nervous 
organization  plus  some  irritating  process  about  the  pelvic 
organs. 

In  the  treatment  of  the  various  nervous  symtoms  at- 
tending chronic  uterine  or  ovarian  disorders  but  little  pro- 
gress can  be  made  toward  a  permanent  cure  as  long  as 
these  conditions  continue  to  act  as  a  cause  ;  here  local 
treatment  is  an  essential  factor.  Fortunately  medical 
science  has  made  great  strides  in  this  direction  of  late 
years,  both  in  accuracy  of  diagnosis,  and  in  new  and  more 
thorough  and  efficacious  methods  of  treatment,  and  it  is 
not  rare  to  see  women  who  have  been  nervously  crippled 


52  PHASES 


for  years  restored  to  health  and  usefulness  in  a  few  weeks 
by  skillfully  conducted  local  measures. 

NERVOUS    DEBILITY     CONNECTED     WITH     DISORDERS     OF 
THE    MALE     REPRODUCTIVE    SYSTEM 

The  reproductive  system  in  the  male,  as  in  the  female, 
is  closely  related  to  the  nervous  system,  and  in  general 
nervous  impairment,  even  where  there  is  no  history  of 
sexual  excess,  various  functional  disorders  of  the  repro- 
ductive  organs,  as  seminal  emissions,  premature  emission, 
a  sense  of  excessive  fatigue  after  temperate  intercourse, 
and  even  a  partial  or  complete  loss  of  power  for  consider- 
able periods  may  occur.  In  some  cases,  without  there 
being  any  true  loss  of  power,  there  is  an  uncertainty  or 
unreliability  with  respect  to  the  sexual  function  which 
renders  the  individual  practically  impotent.  But,  in  the 
large  proportion  of  cases,  sexual  neurasthenia  is  a  direct 
result  of  the  abuses  and  excesses  so  common  among  the 
young.  The  elements  of  this  form  of  nervous  debility 
are:  i.  Excessive  nerve- waste.  No  function  involves  the 
output  of  so  large  a  quantity  of  nerve-force  in  so  short  a 
time  as  the  reproductive;  sexual  excess  empties  the  nerve- 
cells  most  quickly  and  effectively  of  their  nerve-force  and 
induces  a  condition  of  irritability  and  weakness  in  the  cen- 
tral nervous  system.  2.  A  too  early  or  a  too  frequent  ex- 
ercise of  the  reproductive  function  sets  up  certain  morbid 
conditions  in  the  sexual  organs  themselves  ;  these  consist 
of  a  morbidly  irritable,  congested  or  relaxed  state  of  the 
urethra,  or  the  prostate  gland,  or  of  the  seminal  vesicles 
and  their  ducts,  or  of  all  these  conditions  together.  Some 
times,  as  a  result  of  the  continued  irritation,  a  collar  of 
hardened  tissue  forms  about  the  urethra  at  a  point  more 
or  less  deep;  these  strictures  of  large  calibre,  as  they  are 
called,  are  seldom  suspected  by  the  patient,  and  are  only 


PHASES  53 


revealed  to  the  surgeon  in  the  course  of  an  examination. 
When  any  or  all  of  these  deep-seated  morbid  conditions 
becomes  firmly  established,  and  more  or  less  chronic,  they 
act  upon  the  sensitive  nervous  tissue  in  the  spine  and 
brain  like  a  thorn  in  the  flesh;  a  persistent,  continuous, 
abnormal  impression  is  reflected  or  transmitted  back  to 
the  sexual  nerve-centers  in  the  lower  part  of  the  spine, 
and  to  the  entire  nervous  system,  which  is  thus  harassed, 
irritated,  depressed,  and  weakened.  The  excessive  secre- 
tion, the  unnatural  losses,  and  all  the  phases  of  sperma- 
torrhoea, depend  directly  upon  these  morbid  conditions  of 
irritability  and  relaxation,  and  quickly  disappear  when 
these  are  cured.  So,  too,  these  deep-seated  conditions  are 
often  the  cause  of  a  partial  or  complete  loss  of  power,  or 
even  of  a  diminution  in  size — atrophy — of  the  external 
parts.  The  sexual  nerve-centers  in  the  spine  are  the  im- 
mediate sources  of  all  the  power,  tone,  and  nutrition 
manifested  in  the  external  parts;  when  these  centers  have 
been  worried  and  irritated,  perhaps  for  years,  by  the  mor- 
bid conditions  described  above,  they  gradually  lose  their 
power  to  create  and  to  put  out  force;  in  addition,  they 
participate  in  the  general  nervous  debility  induced  by  ex- 
cess; as  a  result,  the  vigor  of  the  muscles  concerned  is 
not  maintained,  the  tone  of  the  veins  may  be  lost,  and 
they  become  relaxed  and  dilated,  the  nutrition  of  the  parts 
may  suffer  from  the  depressed  state  of  the  trophic  sexual 
centers  in  the  spine,  and  the  parts  may  greatly  diminish  in 
size. 

The  strictures  of  large  calibre  mentioned  above  are 
now  known  to  be  one  of  the  most  common  causes  of 
chronic  impotency,  and  many  cases  which  have  resisted 
every  other  form  of  treatment,  after  this  condition  has  been 
discovered  and  removed,  are  quickly  restored  by  means  of 
electricity  and  other  measures.  A  new  procedure,  per- 


54  PHASES 


fected  within  a  year  or  two,  now  enables  the  surgeon  to 
melt  away  these  strictures  by  means  of  a  mild  galvanic 
current,  which  is  passed  directly  through  the  part,  and 
which  causes  little  or  no  pain.  3.  The  unnatural  losses 
are  the  feature  of  sexual  neurasthenia  which  generally 
gives  the  patient  the  most  anxiety,  but  they  are  by  no 
mean;j  the  most  important  element  in  the  case.  In  chil- 
dren, long  before  there  is  any  seminal  secretion  to  lose, 
and  in  the  female,  who  has  no  true  seminal  secretion,  bad 
habits  may  produce  all  the  general  symptoms  of  chronic 
spermatorrhoea;  these  losses  quickly  disappear  when  the 
local  disorders  upon  which  they  depend  are  removed. 
The  excessive  nerve-waste,  the  depressing  emotions  of 
anxiety  and  remorse,  and  the  chronic  morbid  conditions 
in  the  reproductive  tissues  are  much  more  important  fac- 
tors, and  together  make  up  a  peculiarly  distressing  form 
of  nervous  impairment. 

The  prominent  part  which  the  nervous  system  plays  in 
these  functional  disorders  of  the  reproductive  organs  leads 
many  eminent  authorities  to  classify  them  among  nervous 
diseases,  as  "The  Sexual  Neuroses."  Dr.  Beard  says, 
( '  Spermatorrhoea  is  usually  a  nervous  disease.  It  was 
formerly  supposed  to  be  a  local  difficulty  merely,  a  result 
of  local  inflammation.  The  truth  is  that  it  is  like  dys- 
pepsia, usually  a  symptom  of  constitutional  debility.  It 
is  more  frequently  a  result  than  a  cause.  The  masses  of 
the  people  have  very  erroneous  ideas  upon  this  subject." 

Much  cant  has  been  indulged  in  by  writers  on  the  sub- 
ject of  sexual  vices  among  the  young;  the  victim  of  a  boy- 
ish foolishness,  for  which  his  parents  and  teachers  were 
perhaps  more  to  blame  than  he,  is  made  to  feel  that  he 
is  a  kind  of  moral  monster.  It  seems  to  me  that  these 
habits  in  many  boys  are  a  natural  consequence  of  certain 
unwholesome  surroundings  rather  than  a  manifestation 


PHASES  55 


of  any  innate  viciousness.  For  several  years  about  the 
age  of  puberty  the  reproductive  system  is  in  a  more 
or  less  exalted  and  susceptible  state,  while  it  is  being  de- 
veloped and  elaborated  into  the  fullness  of  manhood. 
During  this  period,  even  carefully  reared  youths  are  ex- 
posed to  many  subtly-acting  impressions  and  evil  influ- 
ences. Especially  is  this  so  of  city  boys,  whose  budding 
senses  are  assailed  by  suggestive  pictures  in  hundreds  of 
shop-windows,  who  can  hardly  avoid  an  exciting  and 
prurient  literature,  who  use  tobacco,  and  whose  nervous 
systems  are  rendered  unduly  susceptible  by  an  insufficiency 
of  healthful  out-of-door  life.  When  we  reflect  how  boys 
are  abandoned,  uninstructed  and  unwarned,  to  all  the 
evil  possibilities  which  surround  this  most  susceptible 
stage  of  life,  it  is  not  strange  so  many  are  injured  in  this 
way. 

Functional  disorders  of  the  reproductive  system  have 
not  always  received  the  consideration  at  the  hands  of  the 
regular  medical  profession  which  their  importance  deserves, 
and  as  a  result,  many  of  these  cases  of  nervous  impairment 
have  sought  help  from  charlatans  of  the  worst  type;  the 
worriments  and  despair  resulting  from  these  unfortunate 
experiences  often  seriously  aggravate  the  trouble.  The 
mental  condition  is  an  element  of  sexual  neurasthenia 
which  the  physician  who  treats  these  casts  successfully 
must  correctly  appreciate  ;  this  is  often  one  of  chronic  se- 
cretly-borne worry  plus  an  exaggerated  sensitiveness  in 
respect  to  the  origin  and  nature  of  the  trouble. 

This  mental  wretchedness  must  be  ended  as  speedily  as 
possible.  In  a  large  proportion  of  cases  a  positive  cure 
can  be  promised  without  hesitation  by  the  physician  who 
is  properly  equipped  for  this  kind  of  work,  and  this  sub- 
stitution of  bright  prospects  for  anxiety  is  a  powerful 
remedy  to  begin  with.  And  if,  in  his  intercourse  with 


P6  PHASES 


his  patient,  the  physician  be  imbued  with  a  broad  charity, 
a  kindly  sympathy,  and  an  earnest  desire  to  relieve  a  con- 
dition, that  is,  in  some  respects,  peculiarly  unhappy,  this 
fact  will  often  be  as  truly  remedial,  in  its  way,  as  med- 
icines, electricity  or  any  tangible  remedy. 

THE  RELATION  OF  NERVOUS  IMPAIRMENT  TO  LONGEVITY 

In  a  large  proportion  of  cases  chronic  nerve-weakness 
does  not  threaten  life;  it  cripples  and  incapacitates  the 
subject  and  may  render  him  more  or  less  miserable  through 
a  long  life.  It  has  even  been  stated  that  the  neurasthenic 
condition  in  some  degree  protects  the  individual  against 
acute  inflammations,  and,  as  a  fact,  acute  diseases,  as 
pneumonia,  are  not  very  common  among  this  class  oi 
persons;  then  the  neurasthenic  invalid  gets  into  the  habit 
of  taking  care  of  himself — after  he  becomes  an  invalid — 
and  this  habit  protects  him  against  many  causes  oi 
acute  disease.  So  with  many  nervous  invalids,  especially 
those  in  whom  the  digestive  powers  remain  fairly  good, 
the  chances  are  that  they  will  outlive  many  of  their  more 
robust  acquaintances. 

A  few,  seldom  young,  persons  die  from  no  other  ap- 
parent cause  than  nervous  exhaution;  they  are  worn  out. 

Within  a  few  years  some  authorities  have  stated  that 
certain  organic  diseases,  as  Bright' s  disease,  diabetes,  and 
disease  of  the  blood-vessels  of  the  brain  which  causes 
apoplexy,  are  sometimes  the  direct  result  of  chronic 
nervous  impairment;  the  prolonged  ill-nourishment  of 
the  tissues  is  believed  by  these  observers  to  result  in 
actual  changes  or  degenerations  in  certain  organs.  This 
theory  is  not  established,  but  is  probable  in  some  cases. 

Acute  brain  exhaustion  is  sometimes  a  cause  of  insanity ; 
the  derangements  of  the  brain  circulation,  and  the  sleep- 
lessness largely  contributing  to  this  result,  and  the  evi- 


PHASES  57 


dence  that  acute  nervous  prostration  sometimes  causes 
fatal  organic  disease  is  much  clearer  than  that  with  re- 
spect to  chronic  neurasthenia. 

THE    INCONSTANCY    OF    NEURASTHENIC    SYMPTOMS 

is  one  of  their  peculiarities  in  many  cases.  Within  the 
limits  of  a  week  some  patients  present  the  appearance  of 
blooming  health  or  look  as  if  ready  for  the  grave.  One 
day  a  man  may  be  active  and  enthusiastic,  the  next 
fatigued  and  depressed.  One  day  he  may  be  cheerful, 
even  vivacious,  the  next  silent,  inelastic,  listless.  The 
functions  of  digestion  and  of  reproduction  may  be  unre- 
liable, uncertain,  and  subject  to  sudden  break-downs  or 
to  periods  of  enfeeblement.  In  fact,  the  sufferer  from 
chronic  nervous  impairment  is  apt  to  be,  in  business,  and 
in  society,  a  noticeably  unequal  man. 


REMEDIES. 


THE    CURABILITY    OF    NERVOUS    IMPAIRMENT 

The  resources  of  medical  science  against  the  various 
forms  of  nervous  impairment  are  ample  and  effective,  but 
there  is  no  other  affection  whose  cure  more  depends  upon 
circumstances.  The  personal  character  of  the  patient 
often  determines  the  result  one  way  or  the  other;  not  a 
few  persons  are  unwilling  to  take  the  necessary  trouble  to 
get  well,  others  by  their  weakness  of  will,  or  folly,  frus- 
trate the  best-laid  plans  of  the  physician  for  their  cure. 

We  hear  much  about  good  doctors,  but  less  about  good 
patients;  to  become  a  good  patient,  as  to  become  a  good 
doctor,  often  requires  several  years  of  bitter  expeiience. 
A  long  period  of  suffering  is  sometimes  necessary  to  create 
a  wisdom  that  wl'l  not  scorn  true  remedies  nor  rebel 
against  the  inevitable. 

Some  time  ago  a  lady  consulted  me  for  certain  nervous 
symptoms:  I  took  pains  to  explain  how  the  unnatural 
and  unwholesome  way  of  living,  to  which  she  had  become 
accustomed,  was  at  the  bottom  of  all  her  trouble,  and 
that  this  must  be  radically  changed  before  any  permanent 
benefit  could  be  expected.  I  afterward  learned  from  one 
of  her  relatives  that  she  had  not  been  favorably  impressed 
with  my  ability;  when  asked  about  her  experience  with 
me  she  said:  "Oh,  he  don't  know  anything;  he  told  me 
a  lot  of  stuff  about  diet  and  exercise,  but  he  said  he 
couldn't  cure  me."  Now  this  lady  may  become  a  much 
better  patient  in  the  future  when  her  symptoms  have 
become  intolerable,  and  when  experience  has  taught  her 


59 


that  there  is  no  royal  road  to  health.  The- conditions  are 
most  favorable  in  those  patients  in  whom  intelligence  to 
comprehend  the  situation  is  accompanied  by  an  earnest 
determination  to  get  well. 

The  individuality  of  the  physician  is  sometimes  an  im- 
portant element  in  the  cure;  from  any  one  of  a  dozen  bad 
habits  the  patient  is  sometimes  only  liberated  by  the 
personal  influence  of  the  physician;  neurasthenic  patients 
are  very  apt  to  become  discouraged,  even  when  all  is  go- 
ing well,  and  are  sometimes  only  kept  to  the  programme 
by  a  gentle  but  firm  control;  a  few  cases  exercise  the  skill 
of  the  physician  to  the  utmost,  and  in  these  an  interest  in 
his  patient,  and  a  scientific  enthusiasm  which  rises  with 
difficulty  and  which  leads  the  physician  to  exhaust  the 
resources  of  his  art  before  acknowledging  himself  baffled, 
may  be  saving  qualities.  Given  a  canvas,  a  painter  and 
the  implements  of  his  art,  these  are  to  be  found  in  all 
studios,  but  how  different  the  pictures  which  result  from 
this  combination;  given  a  ship,  a  captain  and  a  storm  at 
sea,  the  physical  conditions  are  the  same  in  all  storms, 
but  how  much  depends  upon  that  which  is  invisible.  So 
in  the  management  of  functional  nervous  disease,  certain 
qualities  of  he-ad  and  heart,  independent  of  purely  techni- 
cal knowledge  and  skill,  have  much  to  do  with  the  result. 
Sympathy,  earnestness,  a  keen  sense  of  responsibility, 
anxious  thought, — these  are  qualities  which  are  often 
given  by  physicians,  but  which  cannot  be  bought,  and 
which  not  unfrequently  make  the  difference  between  cure 
and  chronic  invalidism. 


PRINCIPLES    OF    TREATMENT 

It  will  be  readily  seen  that  there  is  no  uniform  pro- 
gramme of  treatment  for  nervous  impairment;  every  case 


REMEDIES 


requires  careful  investigation,  and  the  choice  and  applica- 
tion of  remedies  are  influenced  by  many  circumstances.  An 
eminent  authority  says: 

' '  Each  case  of  neurasthenia  is  a  study  of  itself.  ...  If 
two  cases  are  treated  precisely  alike  in  all  the  details  from 
beginning  to  end,  it  is  probable  that  one  of  them  is  treated 
wrong. ' ' 

But  while  this  is  true,  there  are  certain  broad  principles 
which  must  be  followed  in  every  case: 

1 .  Certain  adverse  symptoms  which  act  as  direct  obsta- 
cles to  improvement  must  be  removed;  among  these  are 
sleeplessness,  neuralgia  or  headache,  worry,  indigestion, 
etc. 

2.  Local  disorders  which  are  maintaining  or  aggravat- 
ing the  nerve  weakness  must  be  radically  cured;  such  are 
eye-strains,  irritations  about  the  nasal  passages,  stomach 
disorders,  irritations,  congestions,  and  relaxations  about 
the  reproductive  organs  in  either  sex.     Many  of  these 
local   disorders   are   obvious,  others   arc  unsuspected  or 
masked,  and  are  only  ferreted  out  by  the  comprehensive 
knowledge  of  the  physician. 

3.  Brain  and  nerve   nutrition.      The   central   nervous 
system  must  be  reinvigorated,  or  recharged  with  vitality, 
This  renewal  of  vital  force  is  possible,  in  a  greater  or  less 
degree,  in  nearly  all  cases,  but  especially  in  the  young; 
this  is  not  effected  by  stimulation,  which  is  temporary  and 
injurious,  but  by  gently  and  surely  toning  and  building 
up  the  tissue  and  capacity  of  the  nerve-cells,  to  stay  so. 
This  last  result  is  often  possible  only  after  the  other  two 
principles  of  treatment  have  been  effected. 

To  accomplish  these  results,  the  physician  has  choice 
of  a  great  variety  of  remedies,  and  is  offered  a  wide  field 
for  the  exercise  of  his  judgment.  The  remedies  used 
against  nervous  impairment  may  be  ranged  in  two  classes; 


REMEDIES  61 


first,  hygienic  remedies,  the  healing  power  of  nature, 
when  nature  is  given  a  chance;  second,  the  medicines  and 
procedures  which  scientific  medicine  has  learned  in  cen- 
turies of  experience  and  study.  In  most  cases,  both 
classes  of  remedies  are  needed  to  effect  the  cure.  In  some 
cases,  health  is  restored  by  means  of  hygienic  remedies 
alone,  without  the  use  of  drugs  or  of  surgical  skill,  but  it 
is  seldom  that  the  reverse  is  true,  and  that  medicine  and 
local  treatment  cure  without  some  obedience  to  those 
natural  laws  which  rest,  immutable  and  inexorable,  upon 
every  human  life. 

REST    AS    A    REMEDY 

The  "  Rest  Cure,"  in  some  form  or  in  some  degree,  is 
one  of  the  essential  factors  in  the  treatment  of  nearly  every 
case  of  nervous  impairment;  it  is  the  foundation  remedy. 
Rest  is  brain  and  nerve  economy.  When  disease  has 
been  brought  on  and  is  being  maintained  by  an  excessive 
expenditure  of  nerve-force,  it  would  seem  a  simple  propo- 
sition to  lessen  that  expenditure.  But  simple  as  this  logic 
is,  the  inability  or  refusal  of  many  persons  to  realize  it  is 
the  one  thing  that  renders  their  cure  impossible.  When 
a  patient  becomes  well  impressed  with  this  principle  of 
brain  and  nerve  saving,  of  the  prudent  management  of 
his  or  her  particular  nervous  resources,  I  consider  that  he 
has  made- a  long  stride  toward  health.  The  comparison 
of  nerve-force  with  money  has  long  been  a  favorite  one 
with  physicians,  and  "nerve  income,"  "nerve  expendi- 
ture," "nerve  failure,"  "physiological  bankruptcy," 
' '  below  par, ' '  are  phrases  in  common  use  as  illustrations. 

Most  men  are  careful  of  their  money;  they  realize  that 
when  their  capital  is  slowly  and  surely  diminishing,  they 
are  in  a  bad  way.  When  the  merchant's  profits  fall  below 
expenses,  he  does  not  buy  a  lottery  ticket  and  continue, 


62  REMEDIES 


but  reduces  expenses  and  practises  a  careful  economy 
until  business  is  better.  But  when  the  same  merchant 
finds  his  health  becoming  injured  from  over- work,  he  is 
not  apt  to  practise  a  like  wisdom  in  respect  to  his  life- 
force  that  he  does  in  respect  to  his  money.  It  is  hard  to 
get  him  to  cut  down  expenses  at  a  time  when  he  should; 
he  demands  a  ' '  tonic, ' '  and  relies  on  that.  Brain  and 
nerve  economy  is  not  usually  popular  with  patients;  it 
interferes  with  their  plans,  and  involves  sacrifices,  efforts, 
trouble;  the  hypophosphite  and  the  nerve-food  man  seem 
to  offer  a  much  pleasanter  means  of  cure . 

Sleep  is  the  most  valuable  form  of  brain-rest.  During 
the  hours  of  sleep  the  output  of  nerve-force  is  reduced  to 
a  minimum,  and  at  the  same  time  the  blood  is  busily  re- 
pairing the  wear  and  tear  of  the  day.  The  oxygen  of  the 
blood  unites  with  the  worn-out  tissues,  and  heat  is  evolved 
in  this  process.  This  heat  is  converted  into  vital  force, 
as  the  heat  of  an  engine  may  be  converted  into  electricity 
for  lighting  or  other  purposes,  which  vital  force  is  stored 
up  in  the  brain-cells  for  use  the  next  day.  Thus,  each 
morning  we  awaken  with  our  brain  and  nerve  tissues 
charged  with  the  vigor  of  life.  Sleep,  which  the  poet 
long  ago  described  as  "tired  nature's  sweet  restorer,"  has 
in  these  days  become  a  remedy;  and  in  the  great  asylums 
and  hospitals  where  nervous  and  mental  disorders  are 
treated,  the  value  of  prolonged  sleep  is  understood  and 
utilized. 

Sleeplessness  is  a  frequent  phase  of  nervous  impair- 
ment. There  are  two  elements  of  a  good  night's  sleep — 
getting  to  sleep,  and  staying  there.  When  the  circulation 
of  the  blood  is  badly  managed  and  unsteady,  as  explained 
in  the  preceding  chapter,  the  nervous  invalid  may  find 
it  impossible  to  get  to  sleep  because  the  brain  remains  en- 
gorged with  blood  ;  again,  the  irritable  brain- cells  have 


REMEDIES  63 


the  faculty  of  easily  attracting  an  increased  blood-flow  to 
the  brain,  whence  the  enfeebled  blood-vessels  are  unable 
to  remove  it,  and  he  wakes  easily  in  the  night,  and  per- 
haps tosses  from  side  to  side  for  hours. 

Many  devices  are  in  vogue  to  enable  the  nervous  to  get 
to  sleep  and  stay  there;  they  are  all  based  upon  one  or 
the  other  of  these  two  principles  : — withdrawal  of  blood 
from  the  brain,  and  soothing  the  brain-cells  irritated  by 
the  day's  experiences.  A  light  supper  of  raw  oysters,  cr 
a  crust  of  bread,  with  maybe  a  glass  of  beer  at  bed  time 
may  divert  the  blood-wave  from  the  brain  to  the  stomach 
and  induce  sleep.  A  short  walk  in  the  open  air,  a 
brisk  rubbing  with  a  flesh  brush  or  coarse  towel,  or  a 
hot  bath  may  act  in  the  same  way.  A  half-hour  of 
light  reading,  or  better  yet  music  and  cheerful  conversa- 
tion, or  a  cigar,  may  so  tranquilize  the  irritable  brain- 
cells  that  sleep  is  possible. 

A  patient  who  has  tried  all  the  common  plans  against 
sleeplessness  informs  me  that  a  dozen  or  twenty  deep 
inspirations  are  most  effectual ;  this  rapid  loading  of  the 
blood  with  an  excess  of  oxygen  acts  as  a  gentle  stimulus 
to  the  brain-cells  and  to  the  circulation.  The  practice 
of  counting  is  sometimes  effective  by  displacing  other 
thoughts  and  by  the  soothing  influence  of  the  monot- 
onous impression. 

When  simple  plans  do  not  succeed  and  sleeplessness 
becomes  habitual  the  aid  of  the  physician  must  be  in- 
voked. Prolonged  insomnia  may  lead  to  the  gravest 
results  ;  it  is  sufficient  of  itself  to  produce  not  only  com- 
plete nervous  exhaustion,  but  even  mania  and  other  forms 
of  true  insanity.  The  careful  physician  of  to-day  only 
makes  use  of  chloral  and  other  dangerous  drugs  as  a  last 
resort.  By  means  of  hot  bathing,  the  Turkish  bath, 
massage,  electricity,  and  a  certain  principle  of  pressure 


64  REMEDIES 


over  the  great  blood-vessels  of  the  neck  it  is  often  possible 
to  manage  insomnia  without  the  use  of  drugs. 

The  genius  of  modern  chemistry  has,  within  a  year  or 
two,  furnished  the  physician  with  some  valuable  drugs 
against  sleeplessness,  which  have  the  great  advantage  of 
being  comparatively  harmless. 

In  those  callings  requiring  night  work  and  day  sleep 
the  day  sleep  can  never  be  made  to  yield  the  same  restor- 
ation of  nerve-force,  nor  to  afford  the  same  rest  to  the 
brain-cells  that  night  sleep  does.  The  nervous  organs  are 
very  susceptible  to  the  stimuli  of  light  and  sound  and 
thus  a  degree  of  tension  is  maintained  even  in  apparently 
sound  day  sleep  ;  but  even  where  a  perfectly  quiet  and 
darkened  room  is  available  for  day  sleep  some  element  of 
natural  sleep  seems  to  be  wanting. 

Change  is  one  form  of  brain  and  nerve  rest  the  prin- 
ciple of  which  has  been  explained  on  page  15  :  social 
evenings,  holidays  and  vacations  may  be  made  literally 
re-creative. 

A  long  vacation  is  sometimes  the  best  remedy  in 
nervous  impairment ;  if  this  involve  considerable  pecuni- 
ary loss  the  reader  must  lay  his  money  and  his  vitality  in 
the  scales  and  choose  ;  lost  money  is  sometimes  more 
easily  regained  than  lost  vitality.  A  few  months  spent 
largely  out  of  doors  amid  the  agreeable  surroundings 
with  which  this  State  abounds,  will  generally  do  what 
no  medical  art  can  do,  and  may  prevent  disaster. 

Trips  to  Kurope,  the  tour  of  the  great  cities  or  of 
fashionable  watering-places  and  much  railroading,  are, 
as  a  rule  to  be  avoided  when  change  is  sought  for  the 
benefit  of  an  impaired  nervous  system  ;  the  excitements 
of  travel  act  as  stimulants  ;  the  victim  of  over- work  may 
feel  better  for  a  time,  but  the  sight-seeing  is  generally 


REMEDIES  65 


overdone,  the  expenditure  of  nerve-force  is  kept  up,   and 
no  permanent  benefit  is  derived. 

In  many  cases  the  two  indispensable  remedies  are  out- 
door air — ten  or  twelve  hours  daily,  and  quiet  unexciting- 
surroundings. 

Some  men  whose  lives  have  been  absorbed  in  business 
lose  all  interest  in  anything  else,  and  when  turned  out 
into  the  country  by  the  family  physician  for  a  ' '  change  of 
air,"  find  the  life  intolerably  monotonous  and  irksome, 
and  soon  return  to  the  city  and  work.  When  the  case  is 
serious  it  is  worth  the  while  of  such  a  man  to  deliberately 
cultivate  a  taste  for  a  quiet  rural  life. 

Fortunate  the  man  who  has  early  acquired  a  taste  for 
landscape  and  color  ;  or  for  whom  some  little  knowledge 
of  geology  makes  all  the  ground  a  vast  and  interesting 
book  which  he  who  runs  may  read.  For  a  nervous 
system  weakened  and  irritated  by  the  experiences  of  city 
life,  gardening,  or  the  calm  intellectual  diversions  of  the 
amateur  naturalist,  botanizing,  sketching,  collecting,  and 
the  walking  and  climbing  which  they  involve  are  the  per- 
fection of  exercise  and  change,  as  Tyndall's  Hours  ot 
Exercise  in  the  Alps  was  the  perfection  of  those  recrea- 
tions for  healthy  men. 

There  are  many  pleasant  guides  to  the  appreciation  of 
out-of-door  sights  and  sounds.  A  score  of  charming  out- 
door books  teach  the  possible  ' '  harvest  of  a  quiet  eye. ' ' 
Clarence  King's  Mountaineering  in  the  Sierra  Nevadas, 
and  the  whole  fascinating  literature  of  mountain-climbing, 
Tyndall,  Whymper,  and  the  rest,  can  hardly  fail  to 
inspire  the  most  inappreciative  with  a  new  interest  in  life. 
Before  going  to  the  seaside,  there  may  be  obtained  any 
one  of  half-a-dozen  primers  of  marine  zoology,  which  will 
convert  a  common-place  sea-beach  into  a  fairy-land 
abounding  with  objects  of  interest  and  beauty — especially 


66  REMEDIES 


if  such  a  book  as  Charles  Kingsley's  "  Glaukus"  happen 
to  be  the  one  selected. 

In  some  cases  where  the  nervous  resources  have  been 
irrecoverably  overdrawn  the  best  course  is  to  retire  once 
and  for  all  from  the  ceaseless  wear  and  tear  of  city  life 
and  make  a  home  in  the  country  ;  this  is  a  grave  alter- 
native but  it  is  sometimes  the  only  one. 

Unfortunately  the  advice  given  above  is  not  practical 
for  a  large  proportion  of  the  overworked  ;  they  are  neither 
able  to  take  long  vacations  nor  to  abandon  their  posts  ; 
they  must  work  and  they  cannot  help  worrying. 

But  even  in  these  cases  the  physician  may  point  out 
ways  in  which  the  evil  may  be  greatly  lessened,  and  to  do 
this  is  one  of  the  main  purposes  of  this  chapter. 

Many  men  will  be  able  to  reduce  nerve-expenditure 
outside  of  work  sufficiently  to  keep  even  ;  the  lodge, 
church,  and  other  forms  of  night  and  Sunday  work,  or 
the  worrying  and  scheming  which  many  men  do  out  of 
work  hours  may  be  the  straw  that  breaks  the  camel's 
back.  I^et  those  social  obligations  which  are  not  recrea- 
tions be  sacrificed  and  the  hours  of  sleep  increased  ;  if 
such  a  man  can  habituate  himself  to  sleep  ten  or  eleven 
hours  so  much  the  better,  for,  as  we  have  seen,  sleep  is 
nerve  income. 

Worry,  as  the  reader  probably  knows,  is  seldom  sup- 
pressible  by  effort  of  the  will ;  this  evil  must  be  met  by  a 
method  of  substitution  or  displacement ;  it  must  be  kept 
out  or  crowded  out ;  to  this  end  cultivate  a  hobby. 

I  believe  that  music  can  be  made  a  valuable  remedy  in 
many  cases  of  nervous  impairment.  I  know  a  man  who, 
when  evening  finds  him  harassed,  anxious,  excited  by  the 
experiences  of  the  day,  takes  out  his  violin  and  soothes 
his  irritated  brain  and  allays  the  tension  of  his  strung 
nerves  by  the  simple  melodies  which  he  is  able  to  play. 


REMEDIES  67 


An  hour  of  cheerful,  agreeable  music  before  retiring  is 
worth  the  trial  of  any  victim  of  nervous  insomnia ;  the 
fact  that  the  invalid  has  no  skill  or  ear  in  music  need  not 
deter  him  from  a  trial  of  this  advice.  He  must  remember 
that  the  purpose  of  learning  and  performing  is  not  so  much 
the  edification  of  others  as  the  soothing  of  his  irritable 
nerve-cells,  and  the  keeping  out  of  worry  and  care.  Some 
such  quiet  method  is  suitable  when  the  theatre  or  even  a 
social  evening  away  from  home  would  be  too  exciting  or 
too  tiresome.  The  subject  of  nervous  impairment  should 
train  himself  to  avoid,  as  far  as  possible,  all  work  and 
worry  outside  of  business  hours.  Conjugal  duties  must 
be  reduced  to  a  minimum.  So,  too,  it  may  be  necessary 
to  effect  a  complete  change  in  the  daily  life  of  the  woman 
of  fashion  or  of  the  overworked  mother  and  housewife. 
With  many  thin,  nervous,  irritable  school-children,  almost 
the  only  treatment  necessary  is  a  year's  vacation,  spent, 
as  much  as  possible,  in  the  open  air. 

Of  course  the  principle  of  rest,  or  nerve  economy,  is 
especially  indicated  in  all  local  forms  of  nerve-weakness  ; 
over-used  eyes,  vocal  organs,  stomachs  or  sexual  organs 
must  be  rested  by  a  regime  of  strict  temperance,  or,  in 
some  cases,  of  total  abstinence  for  a  time. 

OXYGEN    AND    EXERCISE. 

We  have  noted  the  part  that  oxygen,  the  essential  ele- 
ment of  the  air  we  breathe,  plays  in  the  production  of 
nerve-force.  Oxygen  reddens  the  blood  ;  when  the  dark, 
almost  black,  blood  of  the  veins  is  exposed  to  the  air  in 
the  lungs,  it  instantly  takes  on  the  vivid  scarlet  hue  of 
arterial  blood.  A  daily  full  supply  of  out-door  air  is  the 
most  valuable  tonic  and  vitalizer  for  the  nervous  system 
in  existence, — without  any  exception. 

One  to  six  thousand  lungfuls  (not  sniffs)  of  out-door 


68  REMEDIES 


air  taken  daily  for  a  few  months  will  accomplish  more  to- 
ward restoring  the  vigor  of  an  impaired  nervous  system 
than  will  phosphorus,  hypophosphites,  iron,  quinine, 
strychnine,  coca,  or  any  of  the  other  substances  classified 
as  nerve-tonics,  and  more  than  the  wisest  combination  of 
these  medicines  can  accomplish,  without  this  remedy. 

Oxygen  exerts  a  direct,  positive,  certain  influence  upon 
the  nutrition  and  life  of  the  nerve-cells  ;  under  its  influ- 
ence nerve-force  is  made  more  rapidly  and  in  larger  quan- 
tity, and  a  larger  amount  of  food  is  able  to  be  assimilated  ; 
it  is  a  tonic  in  the  best  sense  of  that  much-abused  word. 
For  these  reasons,  nervous  invalids  should  spend  as  much 
time  as  possible  in  the  open  air.  I  do  not  mean  to  advise 
an  indiscriminate  exposure  to  all  weathers  for  feeble  per- 
sons ;  this  oxygen,  like  all  remedies,  may  be  so  unwisely 
used  as  to  do  harm,  and  here  climate  is  often  an  impor- 
tant adjuvant  or  corrective  element  in  the  treatment. 

The  mild  and  equable  climate  of  California,  by  permit- 
ting the  full  and  continued  use  of  out-of-doors  as  a  rem- 
edy, is  as  valuable  to  the  nervous  as  to  the  consumptive. 
With  respect  to  climate,  my  experience  is  that  a  moist 
sea-coast  air  will  benefit  a  larger  proportion  of  cases  than 
a  dry  interior  climate,  when  the  nasal  passages  or  lungs 
need  not  be  taken  into  consideration.  The  question  of 
climate  is  best  decided  for  each  by  the  physician  who 
knows  him  best ;  but,  whether  sea-air,  with  its  medi- 
cation of  sea-salts  and  iodine,  or  the  balsamic,  ozone- 
charged  air  of  the  mountains  be  resorted  to,  benefit  will 
be  likely  to  result.  Simple  change  from  accustomed  air  is 
often  more  valuable  than  any  particular  climatic  quality. 
Residents  of  the  hot,  dry  valley  and  foothill  region  of  Cali- 
fornia are  benefited  by  a  visit  to  the  coast,  and  for  some 
of  these  persons,  in  winter,  the  city,  with  its  miles  of 
dry  sidewalks,  its  cable-cars,  and  the  innumerable  mental 


REMEDIES  69 


diversions  to  be  found  there,  is  the  best  place  to  seek  a 
change  of  climate ;  the  city  is  a  delightful  play-ground, 
though  it  is  apt  to  be  a  hard  work-shop. 

For  the  residents  of  the  city  in  which  I  write  the  Santa 
Cruz  mountains  offer  many  advantages.  In  this  region 
is  to  be  found  a  beautifully  clear  atmosphere,  where  the 
smell  of  the  sea  is  mingled  with  the  spicy  fragrance  of 
the  redwoods,  and  where,  within  the  radius  of  a  few 
miles,  a  great  variety  of  charming  landscape  encourages 
the  stranger  to  walk  or  climb.  Southern  California  is  a 
naturally  charming  vacation  ground,  and  its  value  to  the 
depressed  and  enfeebled  nervous  invalid  is  enhanced  at 
this  time  by  the  cheerful,  hopeful,  bustling  character  of 
its  population ;  the  moral  atmosphere  is  as  tonic  and 
piquant  as  the  physical.  For  the  stranger  Mr.  Van  Dyke's 
valuable  book,1  Mr.  Roberts'  Santa  Barbara,2  and  the 
widely-read  ' '  Ramona, ' '  are  three  most  pleasant  introduc- 
tions to  this  favored  region. 

The  Sandwich  Islands  trip  is  a  good  remedy  for  many 
nervous  invalids.  The  sea  voyage  is  not  too  long — about 
seven  days  by  steamer,  and  the  moist,  equable  climate  of 
the  islands  exerts  a  soothing  influence  upon  an  irritated 
and  weakened  nervous  system.  The  effect  of  the  com- 
plete change  of  scene  and  daily  life  is  also  very  valuable. 

Exercise  is  a  good  remedy  in  nervous  debility,  but  it 
must  be  proportionate  to  the  strength  of  the  individual — 
like  a  bottle  of  medicine,  it  has  its  dosage  and  its  direc- 
tions for  use.  Exercise  of  the  muscular  system  has  long 
been  looked  upon  as  a  kind  of  antidote  to  the  ill-effects 
of  a  sedentary  life,  and  muscular  development  has  been 

1  Southern  California  ;  Its  Valleys,  Hills  and  Streams  ;  Its  Ani- 
mals, Birds  and  Fishes ;  Its  Gardens,  Farms  and  Climate,  by  Theo- 
dore S.  Van  Dyke:  New  York,  1886. 

2  Santa  Barbara  and  Around  There,  by  Edwards  Roberts.  Boston, 
1886. 


70  REMEDIES 


confounded  with  health.  By  a  system  of  training,  a  man 
may  build  up  large  muscles  and  yet  be  far  from  well,  and 
it  is  a  fact  that  professional  athletes  are,  as  a  class,  short- 
lived. The  chief  value  of  exercise  in  nervous  impairment 
is  the  loading  of  the  blood  with  oxygen,  and,  for  the 
nervous,  exercise  should  be  modified  in  three  ways  :  It 
should  be  moderate,  it  should  be  agreeable,  and  it  should 
take  place,  as  far  as  possible,  in  the  open  air.  Muscular 
exercise  involves  the  expenditure  of  nerve-force,  and  he 
whose  nervous  resources  are  limited  should  be  careful  not 
to  expend  too  much  in  this  direction.  A  half-hour  at 
tennis  may  leave  a  man  glowing  and  invigorated,  when 
two  hours  of  it  will  fag  and  injure  him.  For  the  compar- 
atively strong  who  are  suffering  from  some  of  the  minor 
forms  of  nervous  impairment,  long  days  of  hunting  or 
fishing,  mountain-climbing,  which,  according  to  Tyndall, 
' '  rescues  the  blood  from  that  fatty  degeneration  which  a 
sedentary  life  is  calculated  to  induce,"  or  even  regular 
labor  in  the  orchard  or  vineyard  may  be  of  great  benefit, 
but  for  more  or  less  enfeebled  persons  some  light  form  of 
exercise,  as  walking,  riding  or  sailing,  is  best.  Solitary 
exercise  in  the  gymnasium  is  of  little  benefit  to  the  ner- 
vous ;  the  putting  up  of  dumb-bells,  the  use  G.?  the  health- 
lift,  and  the  various  devices  resorted  to  from  a  feeling  of 
duty  are,  so  far  as  the  nervous  system  is  concerned,  far 
inferior  to  merely  sauntering  in  the  open  air.  Frequent 
holidays,  vacations  and  Sundays  spent  out-of-doors  will 
enable  many  an  overworked  and  worried  city  man  to  hold 
his  own  in  the  face  of  very  adverse  circumstances. 

CONCERNING  BRAIN  AND  NERVE  FOODS 

Chemical  analysis  shows  that  the  brain  is  composed 
chiefly  of  water,  fat,  albumen  and  phosphorus.  The  nu- 
trition of  this  brain  and  nerve  tissue  may  be  analyzed 


REMEDIES  71 


into  three  elements :  First,  the  food  ;  second,  the  diges- 
tion of  it ;  third,  the  picking  up  from  the  blood  by  the 
brain  and  nerve  tissues  of  those  substances  which  they 
require — the  assimilation  of  it.  Thus  the  mere  swallow- 
ing of  any  substance  is  at  most  only  one- third  of  the  way 
to  brain  and  nerve  feeding.  When  the  cells  of  the  ner- 
vous system  become  weakened  from  any  cause  this  weak- 
ness involves  their  whole  physiological  life.  Not  only  is 
their  function  of  giving  out  force  impaired,  but  their 
power  of  attracting  and  appropriating  nourishment  from 
the  blood-current  is  also  impaired. 

The  vigorous  young  nerve-cells  of  a  country  boy  will 
extract  from  even  a  poor  diet  an  abundance  of  nerve-force, 
which  is  exhibited  in  his  firm  flesh,  toned  muscles  and 
tireless  activity.  The  enfeebled  nerve-cells  of  an  aged 
millionaire  cannot  extract  from  the  most  succulent  and 
nutritious  diet  a  similar  amount  of  force  ;  his  flesh  is 
flabby,  his  muscles  unsteady  and  his  powers  limited. 
This  may  serve  to  illustrate  why  nervous  invalids  derive 
no  great  benefit  from  preparations  of  phosphorus  and  sub- 
stances supposed  to  be  '  *  nerve-foods. ' '  If  these  drugs 
were  far  more  nutritious  than  they  really  are,  and  if  the 
blood  of  the  man  with  weakened  nerve-cells  were  loaded 
with  phosphorus,  benefit  would  not  necessarily  result. 
The  weakened  nerve- cells  can  only  assimilate  a  limited 
quantity  of  phosphorus,  and  when  this  substance  is 
brought  to  them  in  unusual  amount  by  the  blood,  it  is  un- 
used, carried  away  again  and  excreted  from  the  system. 

The  brain  and  nerves  feed  upon  the  blood,  and  a  rich, 
pure  blood,  well  charged  with  oxygen,  is  the  best  nerve- 
food.  This  quality  of  blood  is  best  made  from  natural 
foods ;  it  is  hard  to  improve  upon  the  Creator's  method 
of  blood-making. 

Whenever  my  reader  feels  that  he  needs  a  nerve-food 


12  REMEDIES 


the  wisest  thing  he  can  do  is  to  put  himself  in  the  hands 
of  his  physician,  but  if  he  is  not  quite  wise  enough  for 
this  some  suggestions  will  be  of  value  to  him. 

A  full  daily  supply  of  out-door  air  is  of  the  first  impor- 
tance in  brain  and  nerve  feeding.  This  oxygen  must  be 
taken  every  day,  and  the  more  the  better,  for  it  is  one  of 
the  few  remedies  that  is  not  apt  to  be  abused.  If  my 
reader  have  no  respect  for  nor  confidence  in  a  remedy  so 
cheap  and  simple,  the  oxygen  can  be  had  of  certain  manu- 
facturers in  rubber  bags  at  so  much  per  gallon.  This 
roundabout  way  of  using  oxygen  is  not  nearly  so  effica- 
cious in  nervous  exhaustion  as  the  out-door  plan,  but  it 
seems  to  suit  some  persons  better.  Lest  I  be  suspected  of 
being  more  enthusiastic  than  sound  upon  this  subject,  I 
will  attempt  to  explain,  briefly,  the  relationship  which 
exists  between  oxygen  and  nerve  nutrition  ;  to  make 
this  explanation  complete  necessitates  the  repetition  of  a 
statement,  but  repetition  is  one  of  the  essentials  of  good 
teaching. 

1.  Oxygen  is  the  most  efficacious    known   tonic   for 
the  nervous  tissues  ;    it  comes   into  direct  contact  with 
the  brain  and  nerve  cells,  vivifies  them,  and  helps  them 
to  help  themselves ;  by  improving  the  vigor  of  the  nerve- 
cells  it  improves  the  digestive  power  which  depends  upon 
these  nerve-cells,   and  thus   insures   a  better  quality  of 
blood. 

2.  The  reduction  of  food  in  the  stomach  and  intestines 
to  a  liquid  is  not  the  whole  process  of  blood-making.     Be- 
fore this  nourishing  fluid,  chyle,  reaches  the  general  circu- 
lation a  large  part  of  it  must  pass  through  the  liver,  where 
it  is  subjected  to  some  important  modifications.      Of  this 
food-stream,  the  starches,  sugars  and  alcohol  are  partially 
burned   up — by  chemical  union  with  the  oxygen  of  the 
blood — they  are  oxidized,  and  in  this  process  animal  heat 


REMEDIES  73 


is  evolved ;  we  have  already  noted  that  heat  is  convertible 
into  nerve-force.  The  peptones,  which  represent  the  more 
hearty  foods,  the  meats,  etc.,  are  also  subjected  to  the 
action  of  oxygen.  These  nitrogenous  foods,  or  peptones, 
are  usually  eaten  in  larger  quantities  than  the  body  has 
any  need  of,  and  one  of  the  uses  of  oxygen  in  the  body 
is  to  dispose  of  this  surplus — to  so  change  it  that  it  can 
be  excreted  from  the  system.  It  does  this  by  oxidizing 
the  excess  of  meat-food  and  gradually  converting  it  into 
a  substance  called  urea.  This  urea,  the  product  of  per- 
fect oxidation,  is  unirritating  and  soluble  in  the  blood, 
and  thus  is  able  to  be  filtered  out  through  the  kidneys 
without  injury ;  the  urine  is  largely  a  solution  of  urea. 
When  the  amount  of  oxygen  in  the  blood  is  not  propor- 
tionate to  the  amount  of  food,  either  as  a  result  of  seden- 
tary habits  or  of  over-eating,  or  of  both  together,  this 
process  of  oxidation  is  imperfect ;  the  resulting  waste 
substances  fall  short  of  urea ;  they  are  more  irritating ; 
they  are  not  very  soluble  in  the  blood,  and  hence  are  not 
easily  removable  by  the  kidneys.  In  short,  they  act  as 
unnatural  and  poisonous  substances  in  the  blood.  These 
abnormal  products  of  imperfect  oxidation  are  known  as 
uric  acid,  lithic  acid  and  oxalic  acid,  and  the  condition  in 
which  they  are  present  in  the  blood  is  called  lithaemia,  or 
lithiasis,  and  is  at  the  bottom  of  some  of  the  gravest 
diseases. 

These  substances  may  assist  to  form  an  abnormal  and 
excessive  quantity  of  bile — "biliousness/'  "bilious 
colic;"  they  may  be  laid  down  in  the  joints  or  attack 
almost  any  tissue  in  the  body — gout ;  they  may  irritate 
and  eventually  cause  disease  in  the  blood-vessels  through 
which  they  are  borne — apoplexy,  aneurism  ;  they  may 
irritate  and  set  up  a  chronic  inflammation  of  the  kidney — 


74  REMEDIES 


Bright' s    disease ;    they    may    form    collections    in    the 
urinary  passages — stone  in  the  bladder. 

Nervous,  overworked  men  are  often  great  consumers  of 
meat ;  they  eat  it  by  instinct  to  repair  the  waste  of 
excessive  work.  When  such  a  man  spends  most  of  his 
time  indoors,  breathing  with  only  the  upper  half  of  his 
lungs,  his  oxygen  supply  is  not  apt  to  be  great  enough 
for  perfect  excretion,  and  he  may  eventually  suffer  from 
some  of  the  troubles  mentioned  above. 

There  is  a  class  of  people  who  are  not  nervous,  in 
whom  a  rich  diet,  a  poor  oxygen  supply  and  a  free  use  of 
alcoholic  drinks  sooner  or  later  produce  some  of  the 
graver  forms  of  lithaemia — most  often  Bright 's  disease. 
Alcohol  uses  up  oxygen  very  quickly,  and  leaves  little 
behind  to  attend  to  the  oxidation  of  surplus  meat  foods, 
and  in  addition,  alcohol  is  itself  irritating  to  the  kidneys, 
liver  and  blood-vessels.  L,ithaemia  in  some  of  its  forms 
is  the  national  disease  of  the  beef-eating  and  spirit  drink- 
ing gouty  Englishman,  as  neurasthenia  is  the  national 
disease  of  the  overworked  neuratic  American. 

But  no  theory  of  science  is  needed  to  convince  my 
reader  of  the  value  of  oxygen  in  nerve-feeding  if  he  will 
recall  his  own  experience  ;  most  men  know  that  they  can 
eat,  digest,  and  use  up  a  much  larger  amount  of  food 
when  their  days  are  spent  in  the  open  air,  than  when 
they  are  spent  in  "a  stuffy  office  or  workshop. 

Coming  now  to  actual  foods,  the  fats  stand  highest  on 
the  list  for  the  nervous — cream,  fresh  butter,  the  fat  of 
roast  beef  and  of  beef-steaks ;  the  brain  is  rich  in  fatty 
substances,  and  fat  goes  to  make  heat  and  force.  Fats, 
while  highly  nutritious  to  the  nerves,  are  not  so  easily 
digested  as  lean  meat,  but,  by  keeping  up  his  oxygen,  the 
nervous  invalid  will  find  himself  able  to  manage  more  and 
more  of  these  substances.  I  am  aware  that  nine  men  in 


REMEDIES  75 

ten  who  read  this  book  probably  abhor  fat  meat,  but  I  ad- 
vise such  to  begin  with  small  quantities  and  cultivate  a 
taste  for  it.  Cod-liver  oil  is  a  valuable  food  for  the 
nervous  when  it  can  be  managed  by  the  stomach.  I  pre- 
fer the  plain  oil  to  any  of  the  numerous  emulsions  and 
compounds ;  the  best  way  to  take  it  is  to  float  the  oil  on 
the  top  of  a  very  small  glass  of  beer,  between  the  beer  and 
the  froth,  and  swallow  it  at  a  gulp.  But  if  cod-liver  oil 
does  not  agree  it  had  better  be  avoided,  since  it  has  no 
especial  medicinal  advantages  over  cream;  it  is  simply 
one  of  the  most  assimilable  forms  of  fat. 

Next  in  value  to  the  fats  are  the  unbolted  cereals  ;  first 
of  all,  wheat,  then  oats  and  corn.  Cracked  wheat  and 
cream  is  an  ideal  nerve-food.  Corn-bread,  the  "johnny- 
cake"  of  New  Kngland,  made  of  corn  meal,  eggs,  and 
flour,  thick,  light,  warm,  and  soaked  with  fresh  butter,  is 
a  better  nerve-food  than  can  be  found  on  the  druggists' 
shelves.  Roast  beef  or  juicy  steaks  are  rich  in  the 
elements  of  brain  nutrition,  the  phosphates  of  lime  and 
soda,  and  the  fats,  besides  yielding  a  larger  amount  of 
force  to  the  mouthful  than  any  other  food.  The  prepara- 
tions of  phosphorus  that  are  put  up  by  the  Creator  in  such 
inimitable  packages,  in  the  germ  of  wheat,  oats  and  corn, 
and  in  meats,  have  great  advantages  over  the  artificial 
products  of  the  laboratory  ;  they  are  more  easily  soluble 
in  the  digestive  juices,  and  more  easily  assimilated  by  the 
tissues,  because  they  are  natural.  Fresh  fish  and  shell 
fish  are  light,  easily  digested  foods — when  properly 
cooked — but  they  have  no  special  value  as  brain  and 
nerve  foods.  Celery,  I  may  remark,  since  I  have  been 
often  asked  concerning  it,  has  no  value  whatever  in 
nerve-nutrition.  The  man  with  any  stomach  at  all,  who 
cannot  make  brain  and  nerve  tissue  and  force  upon  the 
diet  I  have  indicated,  will  not  be  likely  to  find  it  in  any 


76  REMEDIES 


product  of  the  chemist's  skill ;  but  I  again  remind  my 
reader  that  the  food  supply  must  be  sustained  by,  and 
proportionate  to,  a  proper  oxygen  supply. 

TEA,  COFFEE,  TOBACCO,  AND  ALCOHOL 

are  rather  causes  than  remedies  in  nervous  impairment, 
but  it  has  seemed  most  convenient  to  discuss  them  in  this 
chapter. 

Concerning  these  substances  it  is  not  possible  to  make 
one  rule  for  the  whole  human  race;  used  temperately 
they  add  a  great  deal  to  the  comforts  of  life  ;  used  intem- 
perately  they  may  create  great  mischief ;  thus  a  danger 
lurks  in  their  moderate  use.  Coffee  and  tea  are  both 
stimulants  to  the  nervous  system,  and  their  habitual  use 
probably  increases  the  sensitiveness  of  the  nervous  tissues  ; 
used  intemperately  these  substances  may  induce  a  high 
degree  of  "  nervousness,"  manifested  in  trembling  fingers, 
palpitations,  disordered  vision,  or  indigestion. 

Tobacco  in  small  quantities  is  a  stimulant  to  the 
nervous  system  of  the  habitual  smoker ;  it  promotes  the 
flow  of  ideas,  increases  digestion  and  circulation  by  its 
stimulant  effect  upon  certain  nerve-centers  in  the  brain, 
and  it  slows  the  processes  of  tissue  waste.  Used  in  excess 
it  becomes  an  irritant  to  the  nerve-centers  ;  the  heart  may 
become  irritable — "smokers  heart;"  the  digestion  may 
fail,  the  eyes  may  become  weakened,  and  trembling 
fingers  betray  the  irritated  and  weakened  condition  of  the 
nerve-cells  within.  Gentle  rubbing  a  flea-bite  soothes  the 
irritated  skin ;  prolonged  scratching  may  destroy  it,  or 
set  up  an  inflammatory  skin  disease.  So,  tobacco,  used 
in  moderation,  by  its  gentle  stimulant  effect  counter- 
irritates  and  soothes  the  brain  and  nerves  excited  by  the 
experiences  of  the  day  ;  prolonged  or  excessively  used,  it 
becomes  an  irritant.  It  is  one  of  the  principles  of 


REMEDIES  77 


physiology,  that  persistent  irritation — over-stimulation — 
of  any  part  eventually  ends  in  exhaustion.  The  fact 
should  be  remembered,  that  persons  of  a  nervous  consti- 
tution and  persons  living  a  sedentary,  indoor  life,  are 
more  susceptible  to  the  action  of  stimulants  and  narcotics 
than  others,  and  that  they  are  more  liable  to  abuse,  and  to 
be  injured  by  them.  With  respect  to  the  use  of  tobacco 
by  children  and  immature  youths  there  can  be  but  one 
opinion  ;  it  is  an  evil  so  great  and  so  important  in  its 
relation  to  the  public  health  as  to  justify  its  suppression 
by  legislation. 

Alcohol  in  small  quantities  is  a  gentle  stimulant  to 
stomach,  heart  and  brain ;  used  in  excess  it  is  one  of  the 
surest  and  most  efficacious  brain  and  nerve  poisons  that 
we  know. 

The  use  of  alcohol  should  be  limited  to  taking  a  little 
wine  for  the  stomach's  sake  ;  a  glass  of  light  wine  is  a 
valuable  addition  to  the  dinner  of  many  nervously- 
impaired  persons. 

The  habit  of  drinking  whisky  between  meals  is  a  bad 
one  for  a  healthy  man,  and  is  highly  injurious  to  him 
whose  nervous  system  is  his  weak  part.  Without  con- 
sidering the  irritant  effect  of  the  alcohol  upon  the  delicate 
stomach  lining  and  liver  tissue,  that  proportion  of 
alcohol  which  escapes  unoxidized  through  the  liver,  in 
circulating,  passes  through  the  finely  organized  brain  and 
nerve  tissues,  upon  which  it  exerts  a  distinctly  poisonous 
effect.  Neither  wine  nor  whisky  should  ever  be  used  as 
"bracers,"  or  stimulants  to  the  nervous  system.  The 
plan  of  working,  or  ' '  keeping  up' '  on  stimulants  so 
common  is  disastrous  ;  no  one  can  long  follow  it  without 
paying  some,  often  a  severe,  penalty. 

Many  of  the  patented  preparations,  to  be  found  in  so 
great  variety  in  the  drug-stores,  with  the  seductive  names, 


78  REMEDIES 


1 '  tonic, "  ' '  restorative, "  ' '  rej uvenator, "  ' '  nerve-food, ' ' 
are  simply  stimulants,  alcoholic  or  drug,  and  do  the  harm 
that  all  stimulants  do.  ' '  The  ladies'  tipple' '  is  a  phrase 
which  a  recent  writer  has  applied  to  that  omnipresent  and 
taking  mixture — "beef,  iron  and  wine."  The  composi- 
tion of  this  compound  varies  with  the  consciences  of  the 
druggists  who  make  it,  but  it  generally  contains  a  good 
deal  of  wine,  and  a  very  little  of  iron  and  beef.  The 
popularity  of  this  mixture  is  a  good  illustration  of  the 
superstitious  faith  that  people  are  apt  to  put  in  drugs. 
One  would  suppose  that  when  a  man  had  decided  to  take 
beef,  wine  and  iron,  he  would  prefer  juicy  steaks  and 
roasts,  with  a  quality  of  wine  of  his  own  choosing,  and 
the  iron  by  itself;  but  the  mixture  representing  the 
virtues  of  dog-meat  and  cheap  wine,  manufactured  to  reap 
as  great  a  profit  as  possible,  has,  in  his  eyes,  acquired 
some  strange  power  in  passing  through  the  hands  of  the 
apothecary. 

BATHS 

are  remedies  of  great  value  to  the  nervous.  The  cold 
sponge  bath  (which  requires  only  a  large  bath  sponge,  a 
bowl  of  water,  and  a  piece  of  oil-cloth)  taken  immediately 
on  getting  out  of  bed.  and  lasting  perhaps  a  minute,  is  a 
valuable  tonic,  and  is  as  strong  a  form  of  cold  bathing  as 
is  advisable  in  many  cases.  In  persons  who  have  plenty 
of  blood,  the  cold  shower,  or  the  plunge  bath,  taken  in 
early  morning  or  in  mid-forenoon,  may  be  better. 

This  question  of  cold  bathing  is  to  be  decided  by  the 
effects  which  it  produces  ;  if  the  individual  comes  to  the 
breakfast  table  after  his  sponge,  sheet,  or  shower  bath, 
warm  and  glowing,  the  bath  has  done  good,  but  if  the 
flesh  is  cooler  than  before  the  bath,  or  if  a  feeling  of  slight 
chilliness  is  experienced,  the  cold  bath  has  done  harm. 


REMEDIES  79 


Many  persons  make  too  long  a  use  of  the  cold  bath.  A 
half  minute,  or  a  single  minute,  spent  in  passing  the 
sponge  over  the  limbs,  chest  and  spine,  followed  by 
vigorous  rubbing  with  a  coarse  towel,  will  often  result  in 
a  fine  reaction  and  a  warm  glow,  when  five,  or  even  two 
minutes  would  be  too  long. 

There  are  doses  of  cold  bathing  as  well  as  of  other 
remedies,  which  must  be  regulated  by  the  powers  of  the 
individual.  In  some,  generally  thin,  persons  any  form  of 
cold  bathing  has  a  depressing  effect,  and  is  inadmissable. 

The  warm  or  hot  bath  is  safer  for  the  thin  and  the  en- 
feebled than  the  cold  bath ;  it  does  not  abstract  heat  from 
the  body  as  the  cold  bath  does.  The  popular  impression 
is  that  warm  baths  are  weakening,  and  this  is  true  if  they 
are  too  prolonged.  But  a  five  minutes'  hot  bath,  to 
which  two  tablespoonfuls  or  more  of  salt  or  mustard  has 
been  added,  acts  as  a  tonic,  and  produces  better  effects  in 
many  persons  than  the  cold  bath.  In  cases  of  sleepless- 
ness a  short  hot  bath  at  bed  time  will  often  procure  sleep 
without  drugging.  I  think  highly  of  short  hot  salt- 
water baths. 

Local  Bathing  of  various  kinds  is  a  remedy  of  the 
highest  value  in  the  various  phases  of  nervous  impair- 
ment ;  as  a  means  of  local  treatment  I  have  found  hot 
water  greatly  superior  to  cold. 

In  the  various  weaknesses  and  congestions  about  the 
female  reproductive  organs  the  local  use  of  medicated  hot 
water  is  more  efficacious  than  any  other  single  remedy, 
and  in  the  various  irritations  and  relaxations  about  the 
male  reproductive  organs  I  use  hot  medicated  solutions, 
externally  and  also  internally,  by  means  of  certain  con- 
trivances, with  the  best  results.  Weak  and  irritable  eyes 
are  generally  more  benefited  by  hot  or  warm  washes  than 
by  the  cold  ones  so  often  recommended.  When  a  weak- 


80  REMEDIES 


ened  nervous  system  includes  among  its  other  enemies, 
some  chronic  inflammatory  process  about  the  nasal  and 
other  upper  air  passages  hot  medicated  solutions  and 
sprays  form  an  important  element  in  the  treatment. 

In  certain  catarrhal  conditions  of  the  stomach  as  well 
as  in  other  forms  of  dyspepsia,  washing  out  the  stomach 
with  various  medicated  waters  by  means  of  a  long  flexible 
tube  is  of  great  benefit ;  this  lavage  is  more  used  by 
European  physicians  than  by  Americans. 

Sea  Bathing  as  a  remedy  ranges  all  the  way  from  a 
powerful  tonic  to  a  powerful  depressant,  according  to  cir- 
cumstances ;  as  a  rule  it  is  not  adapted  to  thin  or  to  weak 
persons.  By  the  robust  it  is  often  overdone  and  made  to 
produce  depression  rather  than  elevation  of  the  vital 
powers.  I  advise  my  reader  to  be  guided  by  medical 
advice  before  resorting  to  this  form  of  bathing.  The  hot 
sea-water  baths,  to  be  found  at  most  seaside  resorts,  are 
much  more  useful,  in  a  large  proportion  of  cases,  than 
open  sea  bathing. 

The  Turkish  or  hot-air  bath  is  very  valuable  in  suitable 
cases  as  a  powerful  sedative  to  the  nervous  system, 
especially  in  cases  of  sleeplessness,  but  it  has  its  dangers, 
and  more  than  any  other  form  of  bathing,  requires  to  be 
directed  by  the  physician. 

THE     USE    AND    ABUSE    OF    DRUGS. 

The  development  of  the  scientific  method  in  observing 
and  in  thinking  has  given  rise  to  a  scepticism  in  medicine 
as  it  has  in  theology  ;  experienced  and  scientific  men 
come  forward  with  such  subversive  statements  as  that 
quinine  is  of  little  value  in  typhoid  fever,  that  strychnine 
will  not  cure  paralysis,  and  that  phosphorus  is  worthless 
as  a  brain  tonic. 

To  read  some  of  the  standard  treatises  upon  materia 


REMEDIES  81 


medica,  a  layman  might  suppose  that  all  diseases  were 
curable  or  relievable  by  drugs,  but  the  best  medical 
thought  of  to-day  tends  toward  a  less  and  less  use  of 
drugs,  and  a  greater  and  greater  reliance  upon  the  healing 
power  of  nature  when  encouraged  by  hygiene  and  good 
nursing. 

Drugs  have  fallen  to  a  secondary  place  as  remedies ; 
they  are  useful,  often  indispensable  ;  they  do  not  so  much 
cure  as  assist  to  cure  ;  they  are  not  now  the  first  remedies 
thought  of  by  the  wise  physician  nor  the  ones  upon 
which  main  reliance  is  placed. 

In  practice  there  is  a  great  pressure  brought  to  bear 
upon  the  physician  to  use  drugs,  and  many  physicians 
yield  to  this  pressure  against  their  best  judgment.  People 
do  not  understand  curing  without  medicine,  and,  what 
often  influences  the  physician  more,  they  are  not  willing 
to  pay  for  such  treatment.  There  is  a  feeling  that  with- 
out the  prescription  nothing  has  been  done  ;  and  (will  the 
reader  believe  it)  there  are  persons  who,  even  when  the 
life  of  a  loved  one  is  at  stake,  are  too  selfish,  too  careless, 
or  too  unintelligent  to  carry  out  the  necessary  nursing ; 
in  such  cases  the  physician  must  do  the  best  he  can  with 
drugs. 

Sufferers  from  any  form  of  chronic  disease  often  become 
addicted  to  self-drugging.  There  seems  to  be  a  tendency 
in  human  nature  to  search  for  some  mysterious  substance 
to  charm  away  disease,  or  to  renew  the  vigor  of  youth  ; 
the  history  of  Ponce  de  Leon  is  daily  repeated  in  every 
drug-store  in  the  land. 

Remedies  about  which  there  is  no  mystery — sunshine, 
pure  air,  proper  food,  and  correct  habits  are  not  very 
popular,  although  their  value  is  felt  and  admitted.  In 
spite  of  repeated  disappointments  the  sick  turn  again  and 
again  to  the  druggist ;  the  druggist  himself  is  not  apt  to 


82  REMEDIES 


use  much  medicine — for  him  the  element  of  mystery  is 
lacking. 

A  glimpse  at  some  of  the  conditions  which  affect  the 
writing  of  a  prescription  may  indicate  that  drug-giving 
is  a  more  intricate  science  than  is  generally  supposed. 

1.  The  effect  of  most  medicines  varies  greatly  with  the 
dose  in  which  they  are  given;  quinine  in  small  doses  is  a 
very  good  remedy  in  certain  headaches  ;  in  large  doses  it 
often   causes   terrible  headache ;    opium  in  small   doses 
strengthens  the  heart ;    in  large  doses  it  weakens  it  to 
death  ;  ipecac  is  one  of  the  surest  emetics  ;    it  is  also  one 
of  the  best  medicines  to  arrest  vomiting ;    arsenic,  in  large 
doses,  poisons  to  death  by  its  irritant   effect   upon   the 
stomach  ;  in  small  doses  it  is  successfully  used  to  soothe 
the  stomach  and  to  allay  vomiting  ;  calomel  is  a  powerful 
purgative — it  is   used    extensively,    in    small   doses,    to 
soothe  the  irritated  stomach  lining. 

2.  The  length  of  time  any   drug  is  continued  affects  the 
result.     All  the  "  bitters"  and  stomachic  tonics,  which  at 
first  increase  the  digestive  power  if  used  too  long  cause 
dyspepsia.     Over-stimulation   ends  in  exhaustion.     The 
same  principle  applies  to  purgative  pills.      Here  is  one  of 
the  ways  in  which  unwise  drugging  does  harm.     Many 
persons  reason  that  if  one  bottle  is  good  twelve  bottles  are 
twelve  times  as  good,  they  pass  in  the  dark  the  point 
where  the  medicine  ceases  to  be  of  any  use  or  becomes  an 
injury,    in   their  particular  case.      This  over-doing  is   a 
characteristic  of  domestic  treatment.     It  is  not  uncommon 
to  meet  persons  who  have  been  having  some  prescription 
refilled  for  years,   not  knowing  that  the  fact  that  it  did 
them  much  good  at  one  time,  does  not  prevent  it  doing 
them    much    harm    later.       The    ' '  tonic' '     habit,     the 
"bitters,"  and  the  purgative  pill  habits  are  as  injurious 
in  their  way  as  the  morphine,  chloral  and  alcohol  habits. 


REMEDIES  83 


For  many  years  the  liver  was  a  favorite  talisman  with 
those  persons  who  live  by  playing  upon  the  fears  cf  the 
sick,  but  lately  the  kidneys  have  become  a  favorite  organ, 
as  affording  even  a  greater  scope  for  business  enterprise. 
Most  of  the  "  kidney-cures"  advertised  so  freely,  are  to 
the  kidneys  what  a  drastic  purgative  is  to  the  bowels — 
they  ' '  scour  them  out. ' '  Some  kidneys  need  a  drastic 
influence,  and  the  individual  feels  better  after  using  these 
compounds,  but  their  continued  use,  or  their  use  in  per- 
sons whose  kidneys  happen  to  be  irritable,  sensitive, 
congested  from  exposure  to  cold,  or  some  other  cause,  or 
in  persons  who  have  inherited  a  tendency  to  inflammation 
of  the  kidney  may  easily  result  in  incurable  Bright' s 
disease. 

3.  The  Combination  of  drugs,  so  that  certain  powerful 
ones  are  modified,  corrected,  assisted,  is  a  principle  oi 
drug-using  that  has  made  great  progress  in  modern 
medicine  ;  this  principle  is  especially  valuable  with 
' '  neurotics, ' '  that  class  of  medicines  used  to  affect  the 
nervous  system. 

</.  Age,  temperament,  inherited  tendencies,  climate, 
occupation,  and  many  other  circumstances  influence  the 
choice  and  the  dosage  of  drugs  ;  twin  brothers  having  the 
same  disease,  might  require  altogether  different  medicines 
and  directions. 

Many  cases  of  nervous  debility  are  best  cured  without 
the  use  of  any  medicines  whatever  ;  all  they  need  is  good 
advice,  and  the  wisdom  to  follow  it,  to  get  well.  There 
is  a  class  of  patients  which  comes  to  the  physician  with  a 
history  of  prolonged  and  copious  ' '  medicine-bibbing  and 
drug-tippling"  as  it  has  been  termed.  They  have  "  tried 
everything' '  and  doctored  for  every  chronic  disease,  with 
physicians  of  every  school,  including  magnetic  healers 
and  the  faith-cure,  and  the  physician  feels  that  he  is  in 


84  REMEDIES 


the  presence  of  a  very  experienced  patient  indeed.  It  is 
not  always  that  this  class  of  patients  can  be  sufficiently 
controlled  to  get  well ;  but  when  they  can  be,  it  is 
remarkable  what  results  can  be  produced  by  a  course  of 
treatment  which  may  not  include  a  single  teaspoonful  of 
medicine. 

Phosphorus. — The  various  preparations  ofphosphorus 
have  considerable  value  in  nervous  debility  when  they  are 
properly  used.  Immense  sums  are  annually  expended 
in  this  country  to  persuade  nervous  invalids  that 
phosphorus  is  a  specific  for  weakened  brain  and  nerves. 
The  logic  of  the  nerve-food  man  is  plausible,  and 
commends  itself  not  only  to  the  ignorant  but  to  the  most 
intelligent.  But,  in  medicine,  good  logic  is  not  always 
good  practice.  The  literature  of  medicine  is  full  of  good 
theories  that  cannot  be  made  to  work  in  the  sick-room. 
There  are  good  chemical  theories  for  the  cure  of 
diphtheria,  consumption,  diabetes ;  but  the  working 
physician  is  not  able  to  realize  their  promises.  The 
chemist  can  formulate  a  perfect  theory  for  making  thin 
people  fat,  and  fat  people  thin,  but  it  has  a  very  limited 
use  in  real  life. 

Phosphorus  exists  in  the  body  of  an  adult  to  the  amount 
of  about  i  j66  pounds  ;  this  occurs  chiefly  as  phosphate  of 
lime,  phosphate  of  soda,  and  is  found  in  the  brain  and 
nerves  in  peculiar  compounds,  the  secret  of  which  even 
the  wonderful  chemistry  of  to-day  is  not  able  to  entirely 
discover. 

The  diet  in  daily  use  by  even  poor  American  men  and 
women  contains  more  than  enough  phosphorus,  in  a 
natural  form,  to  maintain  the  needs  of  the  body.  If, 
during  excessive  nerve- waste  from  overwork,  or  any 
cause,  the  supply  of  phosphorus  is  artificially  increased, 
it  acts,  for  a  short  time,  as  a  stimulant.  Under  the 


REMEDIES  85 


stimulus  of  a  strong,  rich  food  supply  the  tired  nerve- 
cells  are  enabled  to  do  their  work  more  easily  ;  the 
individual  feels  better.  But,  very  soon,  the  capacity  of 
the  nerve-cells  to  assimulate  an  unnatural  quantity  of 
nutriment  becomes  exhausted ;  they  get  dyspeptic,  as  it 
were,  and,  as  the  unnatural  phosphorus  supply  is  brought 
to  them  by  the  blood-current,  they  refuse  it,  are  unable 
to  use  it,  and  it  is  borne  away  again  to  be  excreted  from 
the  system.  Thus,  in  the  end,  much  of  the  expensive 
bottle  of  hypophosphites  finds  its  way  to  the  water-closet. 
If  the  course  of  phosphorus  be  wisely  managed,  if  the 
patient's  nerve- waste  be  cut  down,  and  natural  remedies 
be  brought  to  cooperate  with  the  medicine,  it  may  pro- 
duce permanent  benefit.  But  if  the  patient  has  continued 
his  nerve-expenditure,  or  perhaps  increased  it,  under  the 
stimulating  influence  of  the  drug,  the  result  is  that  when 
the  nerve-cells  have  cloyed  upon  their  high-pressure  diet  of 
phosphorus,  they  are  less  able  than  before  to  manage  the 
natural  phosphorus  supply  of  the  food.  These  remarks 
apply  particularly  to  phosphorus  pills  and  the  hypophos- 
phites. It  is  my  opinion  that  the  reader  may  use  the 
phosphate  of  lime  and  phosphoric  acid  ad  libitum,  for  the 
reason  that  they  do  not  reach  the  nervous  system  at  all, 
the  former  becoming  insoluble  in  the  digestive  juices,  and 
the  latter  forming  phosphates  that  are  likewise  not 
absorbed.  Phosphoric  acid,  however,  has  some  value  in 
other  directions. 

The  late  Dr.  G.  M.  Beard,  of  New  York,  who  probably 
treated  more  cases  of  nervous  exhaustion  than  any  other 
man,  wrote — 

"  Of  phosphates  this  can  be  said,  that,  like  iron  and  quinine, 
they  belong  to  the  list  of  over-praised  and  over-used  remedies,  at 

least  in  their  relations  to    neurasthenia these 

phosphates  and  phosphoruses  and  phosphites  are  good  remedies  in 
nervous  troubles,  but  if  they  had  anything  like  the  specific  power 


86  REMEDIES 


claimed  for  them,  there  would  be  little  need  for  treating  these 
cases ;  most  of  the  patients  that  I  see  have  taken  them  in 
abundance.  All  these  stock  remedies  have  a  certain  power  which, 
in  very  many  cases,  they  soon  expend.  They  reach  the  limit  of 
effect,  beyond  which  they  cannot  be  forced." 

Dr.  Samuel  Wilks,  whose  opinions  are  received  with 
respect  by  the  medical  profession  on  both  sides  of  the 
Atlantic,  in  a  recent  address,  says  : — 

' '  I  never  remember  seeing  more  than  one  patient  the  better 
after  taking  phosphorus,  and  therefore  I  am  bound  to  look  upon 
this  as  a  coincidence.  In  my  private  pharmacopcea  I  have 
attached  to  the  word  phosphorus,  the  name  '  humbug.'  ' 

My  own  faith  in  phosphorus  is  greater  than  that  of  Dr. 
Wilks,  but  I  quote  him  for  the  benefit  of  such  of  my 
readers  as  may  care  to  compare  the  conclusions  of  an 
experienced  and  scientific  physician  with  the  statements 
of  some  of  the  many  shrewd  advertisements  with  which 
the  journals  of  the  day  abound.  The  ignorant  use  of 
phosphorus  may  occasionally  have  serious  results,  and  a 
case  was  recently  reported  in  which  a  woman  had  taken 
a  phosphorus  pill  three  times  a  day  for  two  years,  to 
strengthen  her  brain,  with  the  result  of  causing  a  chronic 
inflammation  and  partial  destruction  of  one  of  the  bones 
of  the  face. 

One  of  the  worst  cases  of  nervous  break-down  that  I  have 
ever  seen  was  in  a  young  married  man,  aged  thirty-three, 
a  victim  of  over- work  and  other  excesses.  He  informed 
me  that  he  had  been  taking  a  preparation  of  the  ' '  hypo- 
phosphites  of  lime,  posash,  manganese,  iron,  quinine  and 
strychnine,"  which  I  found  by  his  bedside,  daily  for  over 
a  year.  It  had  been  recommended  to  him  by  a 
neighboring  druggist,  and  my  patient  informed  me  that 
it  had  done  him  a  great  deal  of  good.  This  young  man, 
with  his  emaciated  figure,  sallow  cheek  and  lustreless 
eye,  was  a  picture  of  premature  old  age.  One  great 


REMEDIES  87 

injury  which  patented  medicines  do  by  their  fine  promises 
is  that  they  encourage  the  nervous  to  rely  on  them  to  the 
neglect  of  other  and  wiser  measures. 

The  Brain  and  Nerve  Poisons. — Many  of  the  phases 
of  nervous  debility,  such  as  sleeplessness  and  neuralgia, 
are  intolerable,  and  have  lead  to  the  popular  abuse  of  cer- 
tain powerful  drugs.  The  rapid  increase  of  the  "drug 
vices"  is  exciting  the  gravest  apprehensions  among 
sanitarians. 

Chloral  hydrate,  the  bromides,  and  morphine  are  power- 
ful sedatives  which  exert  a  distinctly  poisonous  and  de- 
grading effect  upon  the  nervous  tissues  ;  their  prolonged 
use  is  capable  of  reducing  the  strongest  intellect  to  a  state 
of  deplorable  physical  mental  and  moral  weakness.  The 
"  curse  of  chloral"  is  working  terrible  injury  among  the 
great  army  of  nervous  women  ;  this  drug  should  never  be 
used  without  the  constant  supervision  of  a  physician. 

Coca  is  a  drug  which  is  being  exploited  of  late  as  a 
powerful  nerve  "tonic;"  it  is  really  a  brain  stimulant, 
and  its  use  involves  the  dangers  that  the  use  of  any 
stimulant  does.  Coca  is  a  remedy  of  considerable  value 
to  the  physician  ;  in  the  hands  of  the  inexperienced  it  is 
likely  to  prove  one  of  those  edged  tools  of  which  the 
adage  speaks.  Cocaine,  the  active  principle  of  Coca,  is 
capable,  even  when  used  in  moderate  doses,  of  producing 
acute  poisonous  effects,  with  delirium  and  delusions; 
an  instance  of  this  has  lately  passed  under  my  obser- 
vation. Cafleine  and  Indian  hemp,  like  Coca,  are  brain 
stimulants  of  great  use  to  the  physician. 

Concerning  these  brain  and  nerve  poisons  I  wish  to 
emphasize  one  fact ;  they  are  used  temporarily  to  meet 
some  emergency  or  to  combat  some  symptom  which  is  a 
greater  evil  than  they  themselves  are.  Their  prolonged 
use  is  only  justifiable  in  the  gravest  cases,  and  the 


REMEDIES 


responsibility  of  their  use  at  all,  temporary  or  permanent, 
should  rest  upon  the  shoulders  of  a  medical  man. 

Before  leaving  this  subject,  and  at  risk  of  prolixity,  I 
desire  to  impress  upon  my  reader  the  fact  that  a  degree  of 
wisdom  is  essential  to  get  good  effects  from  drugs. 
Wisdom  is  something  more  than  intelligence  ;  it  is  intelli- 
gence plus  experience.  The  girl  of  fourteen  and  the 
matron  of  forty  may  read  the  same  novel,  but  how 
different  are  the  pictures  which  its  pages  suggest  to  each. 
Physicians  have  constant  examples  of  the  fact  that  the 
judgment  of  the  most  intelligent  man  is  worth  little  out- 
side the  range  of  his  own  immediate  experience.  Dr. 
Holmes,  speaking  of  physicians,  says:  ('the  young  man 
knows  the  rules,  but  the  old  man  knows  the  exceptions," 
and  before  reaching  the  wisdom  to  effectually  use  drugs, 
the  brightest  intelligence  must  be  qualified  by  years  of 
observation  in  the  sick  room.  All  physicians  know, 
in  a  general  way,  the  same  remedies ;  the  difference  in 
their  treatment  of  disease  is  the  difference  in  insight,  in 
judgment,  in  carefulness.  It  is  quite  possible  for  two  phy- 
sicians to  so  use  the  same  drugs,  in  the  same  patient,  in 
the  same  disease,  that  one  will  produce  exaggeration,  the 
other  alleviation  of  the  symptoms.  So  let  not  my  reader 
ever  imagine  that  the  prescription  of  some  famous  physi- 
cian, written  for  another,  will  necessarily  be  of  use  in  his 
case,  for  the  most  important  thing  about  a  prescription  ior 
tne  patient,  is  the  wisdom  which  directs  its  use.  The 
knowledge  that  decides  what  remedy  to  use,  how  long  to 
use  it,  when  to  modify  or  combine  it  with  other  remedies, 
when  to  stop  its  use  for  a  time,  and  when  not  to  use  it  at 
all  can  never  be  conveyed  within  the  limits  of  a  patent 
medicine  circular. 

Here  the  story  of  one  of  my  cases  may  be  instructive. 
The  patient  was  a  very  intelligent  young  man — a  college 


REMEDIES  89 


student.  Some  six  months  before  coming  to  me  he  began 
to  treat  himself  for  nervous  debility.  He  avoided  all 
advertised  nostrums,  and  procured  standard  medical 
treatises,  which  he  studied  carefully,  yet  the  conclusions 
which  he  drew  from  these  did  him  considerable  injury. 
During  most  of  this  time  he  was  taking  phosphorus 
pills  with  other  drugs  such  as  strychnine  and  quinine, 
which  he  had  learned  were  powerful  nerve- tonics.  He 
subjected  himself  to  a  daily  cold  shower  bath  as  prolonged 
as  he  could  bear ;  he  exercised  beyond  his  strength  ;  he 
purchased  an  electric  battery  and  used  it  for  several 
months  ;  but,  concluding  that  it  did  him  no  good,  he  gave 
up  its  use.  He  thought  and  worried  constantly  about  his 
condition.  When  he  first  came  under  my  notice  he  was 
quite  thin,  visibly  nervous,  unable  to  study,  his  appetite 
capricious,  and  altogether  he  was  considerably  worse  than 
when  he  began  to  treat  himself.  Upon  taking  charge  of 
his  case  I  abolished  all  medicines  ;  his  cold  bathing  I 
changed  to  a  hot  saltwater  bath  every  other  day,  and  de- 
voted myself  to  curing  certain  local  conditions  of  the 
reproductive  system  which  were  at  the  bottom  of  his 
trouble.  When  this  was  nearly  accomplished  his 
vacation  came  on,  and  I  sent  him  to  the  country  ;  he 
spent  six  weeks  in  the  Santa  Cruz  mountains,  and 
returned  thoroughly  well,  having  gained  sixteen  pounds 
in  weight,  and  he  has  remained  so  since.  One  of  the  most 
important  factors  in  the  cure  of  this  patient  was  the  mental 
load  which  he  got  rid  of  in  thoroughly  understanding  his 
condition  and  prospects,  and  in  shifting  the  responsibili- 
ties of  his  treatment  from  his  own  shoulders  to  those  of  a 
physician. 

The  habit  of  self-drugging,  so  common  among  all 
classes,  immensely  increases  the  aggregate  of  medical 
practice,  and  it  is  not  exactly  worldly-wise  in  the 


90  REMEDIES 


physician  to  advise  against  these  aids  to  his  business. 
But  here  I  may  be  pardoned  an  observation  :  there  is 
a  wide  difference  between  the  true  physician  and  those 
merchants  who  reach  after  and  treat  the  sick  upon 
strictly  business  principles.  The  medical  profession  has 
its  faults,  but  one  of  its  glories  is  that  the  traditions 
of  centuries,  and  a  powerful  professional  opinion  lead  even 
a  selfish  man  to  place  the  welfare  of  his  patient  above  his 
own  pecuniary  interests.  What  a  contrast  between  this 
attitude,  and  that  of  those  pretenders  who  ' '  sell  what 
never  can  be  bought,"  or  of  those  renegades  from  the 
principles  of  medical  honor,  who  realize  the  words  of  the 
great  Abernethy,  ' '  Medicine  is  the  noblest  of  professions, 
but  the  meanest  of  trades. ' ' 


LOCAL     TREATMENT 

When  any  local  irritation,  congestion,  or  weakness  is  at 
the  bottom  of  nervous  debility,  either  as  a  cause  or  as  a 
sequence,  and  is  keeping  it  up  by  its  disturbing  and  de- 
pressing influence  upon  the  central  nervous  system,  local 
treatment  is  generally  necessary  to  effect  a  cure.  In  some 
recent  cases  the  healing  power  oi  nature,  when  permitted 
to  act,  will  right  the  local  trouble,  but  when  it  has 
become  more  or  less  chronic  and  firmly  established,  nature 
requires  to  be  assisted  by  art,  and  here  the  physician  with 
his  knowledge  of  diseased  processes  and  of  anatomy,  is 
most  efficacious.  The  treatment  of  nervous  indigestion  is 
largely  local ;  that  of  the  various  irritations,  congestions, 
and  relaxations  about  the  reproductive  organs  in  either 
sex  is  essentially  local.  General  treatment  and  general 
medication  can  accomplish  little,  while  the  chronic  local 
disturbance  continues  to  act,  but  when  this  is  cured  by 
the  various  means  at  the  command  of  the  physician,  the 


REMEDIES  91 


central  nervous  system,  in  most  cases,  quickly  responds 
to  the  influence  of  correct  living,  pure  air,  sleep,  food,  and 
suitable  medication. 

The  chief  local  remedies  used  against  the  various  forms 
of  nervous  impairment  are  :  i .  Electricity  ;  by  means  of 
appropriate  ' '  current-carriers' '  the  electric  current  may  be 
directed  through  almost  any  tissue  or  organ  in  the  body. 
2.  The  various  local  methods  of  using  hot  and  cold  water, 
medicated  or  not,  internally  as  well  as  externally.  3. 
Local  medication  ;  by  means  of  a  variety  of  instruments, 
some  of  which  are  highly  ingenious,  the  physician  is 
enabled  to  make  direct  application  of  medicinal  substances 
to  the  most  remote  and  deep-seated  parts.  4.  Counter- 
irritation  by  means  of  rubifacients,  the  thermo-cautery 
and  the  galvano-cautery  ;  this  is  a  method  which  I  find 
very  useful  in  certain  cases,  never  pushing  it  so  far  as 
to  injure  the  skin  or  to  cause  much  pain.  5.  Various 
surgical  and  mechanical  procedures  are  occasionally 
necessary. 

ELECTRICITY 

is  one  of  the  modes  of  molecular  motion  like  heat, 
light,  and  sound,  and  is  convertible  into  these  forces. 

Three  kinds  of  electricity  are  used  in  medicine  :  i , 
the  Galvanic,  or  constant  current,  obtained  from  chemical 
action  in  a  number  of  cells,  from  one  to  sixty  ;  2,  the 
Faradic,  or  interrupted  current ;  this  is  an  induced  or 
secondary  current,  obtained  by  the  magnetizing  and 
demagnetizing  of  a  rod  of  soft  iron,  around — but  not 
through — which  a  galvanic  current  from  one  to  four  cells 
is  made  to  pass ;  3,  Static  or  Frictional  electricity,  de- 
veloped by  friction  between  large  revolving  plate-glass 
wheels  and  rubbers  ;  in  using  this  kind  of  electricity  the 
patient  is  insulated  and  charged,  like  a  Leyden  jar,  and 


REMEDIES 


then,  by  touching  his  body  in  various  places  with  metal 
rods,  the  electric  force  is  drawn  out  at  any  desired  point. 
With  a  good  machine  it  is  possible  to  draw  sparks  from 
one  to  twelve,  or  even  more,  inches  long  from  certain 
parts  of  the  body. 

The  two  first  mentioned  forms  of  electricity  are  of  the 
most  value  in  nervous  impairment.  The  galvanic  cur- 
rent gives  little  or  no  pain  ;  it  is  a  silent  current  of  great 
quantity  but  of  low  intensity.  The  Faradic  current,  on 
the  other  hand,  is  readily  felt,  because  of  its  high  degree 
of  intensity.  The  constant  current  has  been  compared  to 
a  mighty,  slowly  moving  river  ;  the  interrupted  current 
to  a  rapid,  leaping,  noisy  mountain  brook.  The  current 
of  frictional  electricity  has  a  high  tension,  but  this  form 
of  electricity  collects  chiefly  upon  the  surface  of  the  body, 
and  never  penetrates  very  deeply  below  the  skin. 

When  the  electric  current  is  passed  through  the  body, 
several  effects  are  produced,  according  to  the  kind  of  cur- 
rent used;  the  particular  nerves  it  is  made  to  traverse, 
the  quantity  or  the  intensity  of  it;  the  direction  it  is  made 
to  take,  whether  toward  or  away  from  the  central  nervous 
system  ;  the  length  of  time  it  is  used  at  each  sitting;  the 
peculiar  susceptibility  of  the  patient,  and  the  dosage  of  it. 

It  is  only  within  a  few  years  that  physicians  have 
practised  the  measurement  of  the  electric  current,  but  this 
assistant  to  the  remedial  use  of  a  powerful  agent  is  most 
important ;  the  battery  differs  on  different  days  ;  ten  cells 
on  Monday  may  represent  a  different  amount  of  electricity 
from  ten  cells  on  Tuesday  ;  again  the  patient's  suscepti- 
bility and  conductibility  may  differ  on  different  days.  In 
many  cases  in  which  electricity  is  used  it  is  highly  im- 
portant to  have  a  uniform,  or  slightly  increasing  dose  at 
each  sitting,  and  this  result  can  only  be  attained  by 
mean.s  of  a  delicate  instrument  called  the  millianipere- 


REMEDIES  93 


metre.  A  recent  writer  remarks:  "I  can  as  easily 
imagine  a  drug  store  without  scales  as  a  medical  battery 
without  a  metre. ' ' 

The  various  remedial  uses  of  electricity  may  be  summed 
up  as  follows  : — i.  It  is  a  powerful  stimulant  and  tonic, 
not  because  it  adds  anything  to  the  tissues  in  passing 
through  them,  but  because  it  rouses  them,  stirs  them  up, 
revivifies  or  puts  new  life  into  them,  and  thus  enables 
them  to  assimilate  and  make  new  tissue  and  force.  2.  It 
may  be  made  to  exert  a  sedative  or  soothing  effect  upon 
internal  organs  that  can  be  reached  in  no  other  way ;  this 
it  does  by  a  gentle  stimulant  or  counter-irritant  action — 
just  as  we  rub  a  flea-bite  to  soothe  the  irritated  skin,  and 
in  congestions  of  deep  seated  parts  it  acts  by  contracting 
the  relaxed  and  flabby  tissues  and  emptying  them  of 
surplus  blood.  3.  It  can  produce  an  alterative  effect, 
i.e.,  cause  a  wholesome  change  in  organs,  the  seat  oi 
some  morbid  process,  in  a  manner  which  we  cannot 
explain.  These  are  the  chief  uses  of  electricity  in  the 
treatment  of  nervous  debility.  As  a  general  tonic  to  the 
central  nervous  system — the  brain  and  spine — it  is  very 
valuable ;  but  it  is  in  the  treatment  of  the  various  local 
phases,  the  irritable  spine,  the  irritable  ovary,  the  irrita- 
tions and  weaknesses  of  the  male  reproductive  organs, 
the  enfeebled  stomach  and  bowels,  that  the  physician  is 
able  to  effect  the  most  gratifying  results  with  this 
remedy. 

The  use  of  electricity  as  a  remedy  requires  a  thorough 
knowledge  of  the  anatomy  of  the  nervous  system,  of  the 
exact  location  of  the  nerve-centers  to  be  treated,  and  of 
the  geography  of  the  various  nerves.  It  is  perhaps  need- 
less to  say  that  the  passing  of  a  current  from  one  hand  to 
another,  through  the  arms,  has  no  value  in  the  treatment 
of  nervous  impairment ;  as  well  might  one  rub  an  internal, 


94  REMEDIES 


medicine  upon  the  hands  and  expect  benefit.  To  do  good 
electricity  must  be  made  to  pass  through  the  diseased 
parts. 

The  electric  belts,  electric  corsets,  electric  brushes,  and 
other  cunning  baits  for  inexperience  are  useless  in  nervous 
impairment,  though  the  purchaser  sometimes  get  his 
money's  worth  in  experience  ;  these  toys  have  no  effect 
other  than  that  which  they  occasionally  produce  upon 
the  imaginations  of  certain  persons.  A  proposal  to 
use  electricity  is  not  unfrequently  met  with  some 
such  remark  as,  "Oh!  I  have  tried  that;  it  is  of 
no  use  in  my  case,"  and  questioning  develops  the  fact 
that  the  patient  has  worn  an  electric  belt,  or  that  he  is  the 
owner  of  a  Faradic  battery.  The  calm  self-confidence  cf 
many  persons  in  their  ability  to  use  tools  which  it  has 
taken  him  years  of  labor  to  learn  to  use  is  sometimes  a 
little  piquing  to  the  physician  ;  a  truer  way  to  put  it  would 
be  that  an  unskillful  use  of  a  good  remedy  has  failed, 
as  unskillful  attempts  in  any  direction  are  very  apt  to  do. 

Scientific  electricity  has  many  other  resources  beside 
those  used  in  the  cure  of  nervous  debility.  As  a  means  of 
diagnosis  it  is  very  valuable  to  the  neurologist;  the 
galvano-cautery  enables  the  surgeon  to  remove  many 
diseased  growths  and  to  perform  many  operations  without 
the  loss  of  a  single  drop  of  blood.  Probably  the  most 
remarkable  action  of  electricity  in  the  human  body  is  that 
known  as  electrolysis,  by  which  abnormal  growths  and 
tissues  are  made  to  disappear  by  being  decomposed  into 
their  chemical  elements.  Two  highly  important  applica- 
tions of  electrolysis  have  been  established  within  the  past 
few  years  ;  the  removal  of  fibroid  tumors  of  the  womb, 
and  the  melting  away  of  stiictures  of  the  male  urethra, 
and  in  each  of  these  cases  electrolysis  replaces  dangerous 
surgical  operations. 


REMEDIES  95 


MASSAGE 

is  a  word  derived  from  a  Greek  word,  signifying  to  press, 
knead,  or  handle.  Massage  is  one  of  the  oldest  remedies 
in  existence  ;  from  time  immemorial,  shampooing,  rub- 
bing, flagellation  and  other  manual  procedures  have  been 
used  in  the  orient,  and  among  various  uncivilized  races. 
Modern  medicine  makes  a  considerable  use  of  this  agent. 
The  chief  procedures  of  massage  are — a  gentle  stroking 
toward  the  heart — effleurage ;  a  vigorous  rubbing — 
massage  a  friction  ;  a  pinching  of  the  muscles — petrissage; 
and  a  tapping  or  percussion  of  the  muscles  and  flesh — 
tapotement 

The  effects  of  these  various  operations  may  be  sum- 
marized as  follows  :  i .  They  increase  the  circulation  and 
activity  of  the  skin,  thus  enabling  it  to  better  perform  its 
function  of  sweating  out  excrementitious  substances  from 
the  blood.  2.  They  improve  the  nutrition  of  the  tissues 
lying  immediately  under  the  skin  ;  this  fatty  layer  is 
increased,  and  thus  the  body  improves  in  weight  and  ap- 
pearance. 3.  They  equalize  the  circulation,  drawling 
blood  away  from  the  brain  or  from  internal  organs,  thus 
relieving  internal  congestions.  4.  They  produce  a 
distinct  sedative  or  tonic  effect  upon  the  terminations  of 
the  nerves,  the  end  organs  of  the  nervous  system,  and 
thus  exert  a  good  effect  upon  the  central  nervous  tissues. 

Massage  will  often  induce  sleep  in  the  sleepless,  or  re- 
place the  intolerable  feeling  of  fatigue  of  which  some 
patients  complain,  by  a  feeling  of  warmth  and  comfort. 
It  is  sometimes  possible  to  stroke  away  a  heidache  or 
neuralgia  as  though  by  magic.  In  various  affections  of 
the  joints  and  muscles,  as  rheumatism,  massage  is  the 
most  valuable  remedy.  The  effects  of  massage  described 
above  are  part  of  the  secret  of  the  ' '  magnetic  healing' '  so 


REMEDIES 


much  in  vogue.  The  magnetic  healer  is  generally  a 
person  who  makes  an  ignorant  and  unscientific  use  of 
massage;  they  often  overdo  it,  and  thus  produce  injury. 

There  are  at  the  present  day,  in  all  large  cities,  a  class 
of  men  and  women  who  have  been  trained  in  this  art,  and 
the  services  of  these  masseurs  and  masseuses  are  often 
utilized  by  the  physician  ;  and  not  a  few  physicianj  make 
personal  use  of  massage  as  adjuvant  to  other  remedies. 

In  thin,  badly-nourished  infants,  a  daily  rubbing  with 
cod-liver,  or  some  other  oil,  for  half-an-hour,  will  produce 
great  benefit ;  they  improve  in  weight  and  appearance 
almost  immediately.  Massage  is  one  of  the  essential  parts 
of  a  mode  of  treating  certain  cases  of  nervous  debility 
described  some  years  ago  by  an  eminent  Philadelphia 
physician,  Dr.  Mitchell.  Dr.  Mitchell's  patients  were 
chiefly  women  in  good  circumstances  who  had  ' '  doctored' ' 
for  years,  and  yet  become  reduced  to  a  chronic  condition 
of  nervous  exhaustion.  He  isolated  them  from  their 
friends  in  a  private  hospital,  exacted  implicit  obedience, 
put  them  to  bed,  and  by  a  combination  of  rest,  forced 
feeding,  electricity  and  massage,  without  medicine,  re- 
turned many  of  these  chronic  invalids  to  their  friends 
plump  and  rosy. 

The  main  facts  of  this  chapter  are  embodied  in  these 

APHORISMS    IN    NERVOUS    IMPAIRMENT 

1 .  Many  cases  of  nervous  impairment  are  incurable  in 
their  earlier  stages,  but  become  curable  in  a  later  stage, 
after  the  subject  has  gotten  very  much  worse  ;    a  period 
of  suffering  is  sometimes  necessary  before  true  remedies 
will  be  permitted. 

2.  Natural  remedies — rest,  sleep,  food,  out-of-door  air,, 
cheerfulness,  are  more  efficacious  than  drugs. 


REMEDIES  97 


3.  Rest — nerve-economy — in  large  or  in  small  doses,  is 
in  most  cases  an  essential  initial  remedy. 

4.  Oxygen  gas  in  the  form  of  out-door  air  is  incom- 
parably the  most  powerful  known  tonic  and  vitalizer  to 
the  nervous  tissues, — in  the  quickness  and  certainty  of  its 
action,  and  in  the  permanence  of  its  results. 

5.  Nerve  nutrition   requires   a  rich  blood -stream,  and 
hungry,  unfagged,  actively  assimilating  nerve-cells.  \The 
four    factors    of    assimilative     or  „  (force-creating)     and 
force-supplying  vigor  in  the  nerve-cells  are   daily   food, 
daily  oxygen,  daily  work  and  daily  rest,  in  proportions 
that  vary  with  circumstances.     Oxygen  is  the  essential 

element  of  the  fire  of  life  as  it  is  of  all  fire ;  a  blood- 
stream fully  charged  with  oxygen  gas  by  deep- 
breathing,  full  and  free  lung-play,  is  from  ten  to  an  infinite 
number  of  times  more  nourishing  to  brain  and  nerves  than 
a  blood-stream  loaded  with  hypophosphites  and  lacking  in 
oxygen. 

6.  Medicines  are  valuable  remedies  in  nervous  impair- 
ment,   but  their   place   is   secondary   and  assistant.     Of 
themselves,  and  without  a  foundation  of  other  remedies 
they  are,  in  most  cases  powerless  to  cure. 

7.  The  nervous  system,  like  the  eye,  is  not  a  good  part 
of  the  body  for  amateur  prescribers  to  experiment  with  ; 
unskillful  drugging  is  apt  to  be  useless  or  worse. 

8.  When  a  chronic,  local  morbid  process  is  at  the  bot- 
tom of,  or  complicates,  nervous  impairment,  the  affection 
may  resist  every  kind  of  general  treatment  until  the  local 
disorder  is  removed. 

9.  Electricity,  used  according    to  the    principles,   the 
nerve-routes  and   the   dosage,    of  modern    electro-thera- 
peutics is  one  of  the  most  efficacious  remedies  against  both, 
the   general   and   the   local  phases   of   nervous    impair- 
ment. 

7 


OS  REMEDIES 


10.  Rest,  change,  sleep,  out-of-door  air,  baths,  food, 
phosphorus,  strychnine,  quinine,  iron,  alcohol,  electricity, 
massage,  and  every  other  remedy  which  experience  has 
shown  to  be  good  in  nervous  impairment,  may  be,  and 
often  is,  so  used  as  to  aggravate  the  disorder  and  make 
the  patient  worse. 


•i 


RETURN  TO  the  circulation  desk  of  any 
University  of  California  Library 

or  to  the 

NORTHERN  REGIONAL  LIBRARY  FACILITY 
Bldg.  400,  Richmond  Field  Station 
University  of  California 
Richmond,  CA  94804-4698 

ALL  BOOKS  MAY  BE  RECALLED  AFTER  7  DAYS 

•  2-month  loans  may  be  renewed  by  calling 
(510)642-6753 

•  1-year  loans  may  be  recharged  by  bringing 
books  to  NRLF 

•  Renewals  and  recharges  may  be  made  4 
days  prior  to  due  date. 

DUE  AS  STAMPED  BELOW 


UUL  1  6  200? 


-r    .          12,000(11/95) 


w  p>        i 

YB  •.:• 


